BACKGROUND: The role of chemotherapy in nodal metastases from penile squamous cell carcinoma is not defined. We evaluated the efficacy of a combination of T-PF (a taxane, cisplatin, and 5-fluorouracil) in neoadjuvant and adjuvant settings. PATIENTS AND METHODS: Since June of 2004, T-PF was administered to stage N2 to 3 patients. With time, neoadjuvant chemotherapy administration prevailed with respect to use in the adjuvant setting. Primary end points were progression-free (PFS) and overall (OS) survival. Secondary objectives were tolerability and activity in the neoadjuvant setting. Nonparametric tests, Kaplan-Meier, and regression analyses were performed. RESULTS: As of October of 2012, 47 consecutive N2 to 3 M0 patients had undergone neoadjuvant (n = 28) or adjuvant (n = 19) T-PF: 18 patients (38.3%) remain disease-free after a median follow-up of 22 months (interquartile range, 17-42 months). The 2-year disease-free survivals were 36.8% (95% confidence interval [CI], 15.2-58.5) versus 7.1% (95% CI, 0-16.7) after adjuvant and neoadjuvant therapy, respectively. N3 metastases were associated with a poorer PFS, and bilateral metastases and mutated p53 were associated with a poorer OS. After neoadjuvant treatment, 43% clinical responses and 14% complete pathologic remissions were recorded, but responses were not associated with survival. Neutropenia (25.5%) was the most frequent Grade ≥ 2 toxicity. CONCLUSION: The T-PF regimen is well tolerated and compares with other regimens in terms of activity and efficacy in the neoadjuvant setting, and very long survivals have been recorded after adjuvant administration. The role of perioperative treatment in these patients remains controversial. Some caution in administering preemptive treatment in patients with resectable disease is needed.
BACKGROUND: The role of chemotherapy in nodal metastases from penile squamous cell carcinoma is not defined. We evaluated the efficacy of a combination of T-PF (a taxane, cisplatin, and 5-fluorouracil) in neoadjuvant and adjuvant settings. PATIENTS AND METHODS: Since June of 2004, T-PF was administered to stage N2 to 3 patients. With time, neoadjuvant chemotherapy administration prevailed with respect to use in the adjuvant setting. Primary end points were progression-free (PFS) and overall (OS) survival. Secondary objectives were tolerability and activity in the neoadjuvant setting. Nonparametric tests, Kaplan-Meier, and regression analyses were performed. RESULTS: As of October of 2012, 47 consecutive N2 to 3 M0 patients had undergone neoadjuvant (n = 28) or adjuvant (n = 19) T-PF: 18 patients (38.3%) remain disease-free after a median follow-up of 22 months (interquartile range, 17-42 months). The 2-year disease-free survivals were 36.8% (95% confidence interval [CI], 15.2-58.5) versus 7.1% (95% CI, 0-16.7) after adjuvant and neoadjuvant therapy, respectively. N3 metastases were associated with a poorer PFS, and bilateral metastases and mutated p53 were associated with a poorer OS. After neoadjuvant treatment, 43% clinical responses and 14% complete pathologic remissions were recorded, but responses were not associated with survival. Neutropenia (25.5%) was the most frequent Grade ≥ 2 toxicity. CONCLUSION: The T-PF regimen is well tolerated and compares with other regimens in terms of activity and efficacy in the neoadjuvant setting, and very long survivals have been recorded after adjuvant administration. The role of perioperative treatment in these patients remains controversial. Some caution in administering preemptive treatment in patients with resectable disease is needed.
Authors: Shreyas S Joshi; Elizabeth Handorf; David Strauss; Andres F Correa; Alexander Kutikov; David Y T Chen; Rosalia Viterbo; Richard E Greenberg; Robert G Uzzo; Marc C Smaldone; Daniel M Geynisman Journal: JAMA Oncol Date: 2018-05-01 Impact factor: 31.777
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: 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
Authors: F A Distler; S Pahernik; G Gakis; G Hutterer; S Lebentrau; M Rink; P Nuhn; S Brookman-May; M Burger; C Gratzke; I Wolff; M May Journal: World J Urol Date: 2019-12-13 Impact factor: 4.226
Authors: Oliver Walther Hakenberg; Desiree Louise Dräger; Andreas Erbersdobler; Carsten Maik Naumann; Klaus-Peter Jünemann; Chris Protzel Journal: Dtsch Arztebl Int Date: 2018-09-28 Impact factor: 5.594