Adam Baumgarten1, Juan Chipollini1, Sylvia Yan2, Sarah R Ottenhof3, Dominic H Tang1, Désirée Draeger4, Chris Protzel4, Yao Zhu5, Ding-Wei Ye5, Oliver W Hakenberg4, Simon Horenblas3, Nicholas A Watkin2, Philippe E Spiess6. 1. Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. 2. Department of Urology, St. George's Healthcare National Health Service Trust, London, United Kingdom. 3. Department of Urological Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 4. Department of Urology, University Hospital Rostock, Rostock, Germany. 5. Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. 6. Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Electronic address: philippe.spiess@moffitt.org.
Abstract
PURPOSE: We evaluated recurrence outcomes of penile sparing surgery in what is to our knowledge the largest multicenter cohort of patients to date. MATERIALS AND METHODS: We retrospectively identified patients treated with penile sparing surgery from May 1990 to July 2016 at 5 tertiary referral institutions. Treatments consisted of circumcision, wide local excision, laser therapy with or without local excision, partial or total glansectomy and glans resurfacing. The study primary end point was local recurrence-free survival, defined from initial treatment to time of local recurrence and estimated with the Kaplan-Meier method. RESULTS: After applying study exclusion criteria 1,188 patients were included in analysis. During the median followup of 43.0 months there were 252 local recurrences (21.2%), of which 99 (39.3%) developed in year 1. Median time to local recurrence was 16.3 months and the 5-year local recurrence-free survival incidence was 73.6%. When stratified by stage, the 5-year local recurrence-free survival rate was 75.0%, 71.4% and 75.9% in Ta/Tis, T1 and T2 cases, respectively (log rank p = 0.748). Of the recurrences 58.3% were treated with repeat organ sparing procedures and the secondary partial (total) penectomy rate was 19.0%. Only margin status was significantly associated with local recurrence on multivariate analysis (p = 0.001). Study limitations included the retrospective design and the heterogeneous clinical approach. CONCLUSIONS: Penile sparing surgery can provide excellent local control for superficial penile tumors as well as for appropriately selected invasive lesions. Strict followup in the early postoperative period is highly recommended.
PURPOSE: We evaluated recurrence outcomes of penile sparing surgery in what is to our knowledge the largest multicenter cohort of patients to date. MATERIALS AND METHODS: We retrospectively identified patients treated with penile sparing surgery from May 1990 to July 2016 at 5 tertiary referral institutions. Treatments consisted of circumcision, wide local excision, laser therapy with or without local excision, partial or total glansectomy and glans resurfacing. The study primary end point was local recurrence-free survival, defined from initial treatment to time of local recurrence and estimated with the Kaplan-Meier method. RESULTS: After applying study exclusion criteria 1,188 patients were included in analysis. During the median followup of 43.0 months there were 252 local recurrences (21.2%), of which 99 (39.3%) developed in year 1. Median time to local recurrence was 16.3 months and the 5-year local recurrence-free survival incidence was 73.6%. When stratified by stage, the 5-year local recurrence-free survival rate was 75.0%, 71.4% and 75.9% in Ta/Tis, T1 and T2 cases, respectively (log rank p = 0.748). Of the recurrences 58.3% were treated with repeat organ sparing procedures and the secondary partial (total) penectomy rate was 19.0%. Only margin status was significantly associated with local recurrence on multivariate analysis (p = 0.001). Study limitations included the retrospective design and the heterogeneous clinical approach. CONCLUSIONS: Penile sparing surgery can provide excellent local control for superficial penile tumors as well as for appropriately selected invasive lesions. Strict followup in the early postoperative period is highly recommended.
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: Hielke M de Vries; Elise Bekers; Matthias N van Oosterom; M Baris Karakullukcu; Henk G van; Fijs W B van Leeuwen; Tessa Buckle; Oscar R Brouwer Journal: J Nucl Med Date: 2021-05-14 Impact factor: 11.082
Authors: Andrej Panic; Henning Reis; Alina Wittka; Christopher Darr; Boris Hadaschik; Verena Jendrossek; Diana Klein Journal: Front Oncol Date: 2021-03-31 Impact factor: 6.244
Authors: Demis N Lipe; Phillip B Mann; Rodrick Babakhanlou; Maria T Cruz Carreras; A Guido Hita; Monica K Wattana Journal: Emerg Med Int Date: 2021-07-27 Impact factor: 1.112