Maarten Albersen1, Arie Parnham2, Steven Joniau3, Varun Sahdev2, Michelle Christodoulidou2, Fabio Castiglione2, Raj Nigam4, Peter Malone5, Alex Freeman6, Charles Jameson6, Suks Minhas2, David J Ralph2, Asif Muneer7. 1. Department of Urology, University College London Hospital, London, UK; Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, Leuven University, Leuven, Belgium. 2. Department of Urology, University College London Hospital, London, UK. 3. Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, Leuven University, Leuven, Belgium. 4. Department of Urology, University College London Hospital, London, UK; Department of Urology, The Royal Surrey County Hospital, Guildford, UK. 5. Department of Urology, University College London Hospital, London, UK; Department of Urology, The Royal Berkshire NHS Foundation Trust, Reading, UK. 6. Department of Histopathology, University College London Hospitals, London, UK. 7. Department of Urology, University College London Hospital, London, UK; NIHR Biomedical Research Centre at University College London Hospitals, London, UK. Electronic address: Asif.Muneer@uclh.nhs.uk.
Abstract
OBJECTIVES: To investigate predictive pathological factors for local recurrence (LR) after glansectomy for penile squamous cell carcinoma (SCC) and to develop a risk score for prediction of LR after glansectomy. PATIENTS AND METHODS: In this retrospective study, we analyzed 117 patients operated between February 2005 and January 2016 in a supraregional penile cancer center in the UK for LR after glansectomy and glans reconstruction. Univariate and multivariate Cox proportional hazards regression was used to identify 4 prognostic indicators for LR. The hazard ratio (HR) of LR was estimated in Kaplan-Meier analysis, and based on these data, we designed a postoperative model for prediction of LR based on 3 risk groups. RESULTS: Median follow-up period was 33.7 (95% CI: 26.8-40.3) months; 12.8% of the patients experienced LR. Univariate Cox proportional hazards regression revealed that the risk factors for recurrence were the presence of perineural invasion, carcinoma in situ, positive margin on definitive pathology, and high-grade disease. Based on Kaplan-Meier analysis stratified by number of factors present, we defined 3 risk groups for LR: low (0,1 risk factors) as reference, intermediate (2,3 risk factors) with HR of 13.9 (95% CI: 1.81-107.04, P = 0.0115), or high risk (all 4 risk factors present) with a HR of 34.2 (95% CI: 3.07-381.81, P = 0,0041). Limitations include the retrospective design and low number of events inherent to the rare nature of penile SCC. CONCLUSIONS: Perineural invasion, carcinoma in situ, positive definitive margins, and the presence of high-grade SCC predict LR following glansectomy. These factors can be used to stratify patients into low-, intermediate-, and high-risk groups for recurrence which may be used to tailor follow-up.
OBJECTIVES: To investigate predictive pathological factors for local recurrence (LR) after glansectomy for penile squamous cell carcinoma (SCC) and to develop a risk score for prediction of LR after glansectomy. PATIENTS AND METHODS: In this retrospective study, we analyzed 117 patients operated between February 2005 and January 2016 in a supraregional penile cancer center in the UK for LR after glansectomy and glans reconstruction. Univariate and multivariate Cox proportional hazards regression was used to identify 4 prognostic indicators for LR. The hazard ratio (HR) of LR was estimated in Kaplan-Meier analysis, and based on these data, we designed a postoperative model for prediction of LR based on 3 risk groups. RESULTS: Median follow-up period was 33.7 (95% CI: 26.8-40.3) months; 12.8% of the patients experienced LR. Univariate Cox proportional hazards regression revealed that the risk factors for recurrence were the presence of perineural invasion, carcinoma in situ, positive margin on definitive pathology, and high-grade disease. Based on Kaplan-Meier analysis stratified by number of factors present, we defined 3 risk groups for LR: low (0,1 risk factors) as reference, intermediate (2,3 risk factors) with HR of 13.9 (95% CI: 1.81-107.04, P = 0.0115), or high risk (all 4 risk factors present) with a HR of 34.2 (95% CI: 3.07-381.81, P = 0,0041). Limitations include the retrospective design and low number of events inherent to the rare nature of penile SCC. CONCLUSIONS: Perineural invasion, carcinoma in situ, positive definitive margins, and the presence of high-grade SCC predict LR following glansectomy. These factors can be used to stratify patients into low-, intermediate-, and high-risk groups for recurrence which may be used to tailor follow-up.
Authors: Vasileios I Sakalis; Riccardo Campi; Lenka Barreto; Herney Garcia Perdomo; Isabella Greco; Łukasz Zapala; Mithun Kailavasan; Tiago Antunes-Lopes; Jack David Marcus; Kenneth Manzie; John Osborne; Benjamin Ayres; Luc M F Moonen; Andrea Necchi; Juanita Crook; Pedro Oliveira; Lance C Pagliaro; Chris Protzel; Arie S Parnham; Maarten Albersen; Curtis A Pettaway; Philippe E Spiess; Scott T Tagawa; R Bryan Rumble; Oscar R Brouwer Journal: Eur Urol Open Sci Date: 2022-05-02
Authors: Sudeh Izadmehr; Dara J Lundon; Nihal Mohamed; Andrew Katims; Vaibhav Patel; Benjamin Eilender; Reza Mehrazin; Ketan K Badani; John P Sfakianos; Che-Kai Tsao; Peter Wiklund; William K Oh; Carlos Cordon-Cardo; Ashutosh K Tewari; Matthew D Galsky; Natasha Kyprianou Journal: Front Oncol Date: 2021-09-27 Impact factor: 6.244
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