PURPOSE: We studied the outcomes in patients with node positive penile cancer who received radiotherapy to inguinal and pelvic nodes. Although half of node positive cases are cured by lymphadenectomy, little data are available on the potential further benefits and toxicities of postoperative radiotherapy. MATERIALS AND METHODS: We retrospectively audited the clinical notes and electronic records of 23 patients referred to a specialist center from 2002 to 2008 who received radiotherapy to the inguinal/pelvic nodes as adjuvant treatment after lymphadenectomy (14), or as high grade palliation for extensive/fixed nodes (8) or extensive local tumor (1). The primary outcome measure was overall survival. Secondary end points were locoregional recurrence-free survival and toxicity. RESULTS: All 13 deaths were due to penile cancer. Patients with adjuvant therapy had better overall survival (66% vs 11%, p<0.001) and locoregional relapse-free survival (56% vs 22%, p=0.03) than those with high grade palliation. Six of 14 adjuvant cases and 7 of 9 with high grade palliation relapsed locoregionally. Of patients with adjuvant therapy and extracapsular spread 1 of 6 with N1, 1 of 4 with N2 and 3 of 4 with N3 disease relapsed (p=0.31). No life threatening toxicity was observed. It was difficult to determine the relative contributions of radiotherapy and surgery to leg/scrotal lymphedema. The study was limited by its small size, which reflects the rarity of this tumor. CONCLUSIONS: Adjuvant radiotherapy appears to have a role after inguinal lymphadenectomy, particularly in patients with extracapsular nodal spread, in whom historically survival rates have been poor. Our findings warrant further investigation in larger series of patients.
PURPOSE: We studied the outcomes in patients with node positive penile cancer who received radiotherapy to inguinal and pelvic nodes. Although half of node positive cases are cured by lymphadenectomy, little data are available on the potential further benefits and toxicities of postoperative radiotherapy. MATERIALS AND METHODS: We retrospectively audited the clinical notes and electronic records of 23 patients referred to a specialist center from 2002 to 2008 who received radiotherapy to the inguinal/pelvic nodes as adjuvant treatment after lymphadenectomy (14), or as high grade palliation for extensive/fixed nodes (8) or extensive local tumor (1). The primary outcome measure was overall survival. Secondary end points were locoregional recurrence-free survival and toxicity. RESULTS: All 13 deaths were due to penile cancer. Patients with adjuvant therapy had better overall survival (66% vs 11%, p<0.001) and locoregional relapse-free survival (56% vs 22%, p=0.03) than those with high grade palliation. Six of 14 adjuvant cases and 7 of 9 with high grade palliation relapsed locoregionally. Of patients with adjuvant therapy and extracapsular spread 1 of 6 with N1, 1 of 4 with N2 and 3 of 4 with N3 disease relapsed (p=0.31). No life threatening toxicity was observed. It was difficult to determine the relative contributions of radiotherapy and surgery to leg/scrotal lymphedema. The study was limited by its small size, which reflects the rarity of this tumor. CONCLUSIONS: Adjuvant radiotherapy appears to have a role after inguinal lymphadenectomy, particularly in patients with extracapsular nodal spread, in whom historically survival rates have been poor. Our findings warrant further investigation in larger series of patients.
Authors: Dominic H Tang; Rosa Djajadiningrat; Gregory Diorio; Juan Chipollini; Zhenjun Ma; Braydon J Schaible; Mario Catanzaro; Dingwei Ye; Yao Zhu; Nicola Nicolai; Simon Horenblas; Peter A S Johnstone; Philippe E Spiess Journal: Urol Oncol Date: 2017-06-27 Impact factor: 3.498
Authors: Andrea Necchi; Gregory R Pond; Daniele Raggi; Sarah R Ottenhof; Rosa S Djajadiningrat; Simon Horenblas; Vincent Khoo; Oliver W Hakenberg; Desiree Draeger; Chris Protzel; Axel Heidenreich; Friederike Haidl; Bernie J Eigl; Lucia Nappi; Kazumasa Matsumoto; Ulka Vaishampayan; Michael E Woods; Roberto Salvioni; Nicola Nicolai; Mario Catanzaro; Patrizia Giannatempo; Daniel M Geynisman; Mirko Preto; Evanguelos Xylinas; Matthew I Milowsky; Sabino De Placido; Giuseppe Di Lorenzo; Guru Sonpavde Journal: Clin Genitourin Cancer Date: 2017-02-27 Impact factor: 2.872
Authors: Kamran Zargar-Shoshtari; Pranav Sharma; Rosa Djajadiningrat; Mario Catanzaro; Ding-Wei Ye; Yao Zhu; Nicola Nicolai; Simon Horenblas; Philippe E Spiess Journal: World J Urol Date: 2015-05-31 Impact factor: 4.226
Authors: Zhigang Yuan; Arash O Naghavi; Dominic Tang; Youngchul Kim; Kamran A Ahmed; Jasreman Dhillon; Anna R Giuliano; Philippe E Spiess; Peter A Johnstone Journal: World J Urol Date: 2018-03-27 Impact factor: 4.226