Shaakir Hasan1, Asha Francis1, Andrew Hagenauer1, Aaron Hirsh2, Deborah Kaminsky3, Bryan Traughber3, Robert Abouassaly4, Rodney Ellis3. 1. College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL. 2. College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL. Electronic address: hirsh.aaron@gmail.com. 3. Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH. 4. Department of Urology, University Hospitals Seidman Cancer Center, Cleveland, OH.
Abstract
PURPOSE: A meta-analysis is presented comparing the overall survival (OS) and local control (LC) rates between penectomy and brachytherapy for penile cancer. METHODS AND MATERIALS: A PUBMED search was conducted with the MeSH terms, "penis, penile, cancer, brachytherapy, penectomy, surgery, treatment" in various combinations. Nineteen retrospective studies published between the years 1984-2012, detailing OS and LC were included. Data were collected per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 2178 males, median age 61 years, were included with 1505 in the surgery group and 673 in the brachytherapy group. The 5-year OS with surgery was 76% compared with 73% with brachytherapy, odds ratio = 1.17 (0.95-1.44, p = 0.128). Penectomy was associated with a higher 5-year LC rate of 84% compared with 79% with brachytherapy, odds ratio = 1.45 (1.09-1.92, p = 0.009). The organ preservation rate for brachytherapy treatment was 74%. Among the surgery patients in a Stage I/II subset, the 5-year OS and LC was 80% (n = 659) and 86% (n = 390), respectively. Of the 209 early stage patients who received brachytherapy, the 5-year OS was 79% and LC was 84%. Chi-square testing demonstrated no difference for either OS or LC for early stage disease. CONCLUSIONS: This meta-analysis is limited by the retrospective nature and inherent selection bias of the data. While penectomy provided better control, there was no survival benefit, implying that in most cases failed brachytherapy could be salvaged with surgery. Additionally, in early stage tumors there was no survival or control difference.
PURPOSE: A meta-analysis is presented comparing the overall survival (OS) and local control (LC) rates between penectomy and brachytherapy for penile cancer. METHODS AND MATERIALS: A PUBMED search was conducted with the MeSH terms, "penis, penile, cancer, brachytherapy, penectomy, surgery, treatment" in various combinations. Nineteen retrospective studies published between the years 1984-2012, detailing OS and LC were included. Data were collected per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 2178 males, median age 61 years, were included with 1505 in the surgery group and 673 in the brachytherapy group. The 5-year OS with surgery was 76% compared with 73% with brachytherapy, odds ratio = 1.17 (0.95-1.44, p = 0.128). Penectomy was associated with a higher 5-year LC rate of 84% compared with 79% with brachytherapy, odds ratio = 1.45 (1.09-1.92, p = 0.009). The organ preservation rate for brachytherapy treatment was 74%. Among the surgery patients in a Stage I/II subset, the 5-year OS and LC was 80% (n = 659) and 86% (n = 390), respectively. Of the 209 early stage patients who received brachytherapy, the 5-year OS was 79% and LC was 84%. Chi-square testing demonstrated no difference for either OS or LC for early stage disease. CONCLUSIONS: This meta-analysis is limited by the retrospective nature and inherent selection bias of the data. While penectomy provided better control, there was no survival benefit, implying that in most cases failed brachytherapy could be salvaged with surgery. Additionally, in early stage tumors there was no survival or control difference.
Authors: Andrey Soares; Icaro Thiago de Carvalho; Aluízio Gonçalves da Fonseca; Antonio Machado Alencar; Carlos Heli Bezerra Leite; Diogo Assed Bastos; João Paulo Holanda Soares; Katia Ramos Moreira Leite; Mário Ronalsa Brandão Filho; Ronald Wagner Pereira Coelho; Sandro Roberto de A Cavallero; Stênio de Cassio Zequi; José de Ribamar Rodrigues Calixto Journal: J Cancer Res Clin Oncol Date: 2020-10-26 Impact factor: 4.553