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Lessons learnt in the management of primary invasive penile cancer in an Australian tertiary referral centre: Clinical outcomes with a minimum 48 months follow-up study

대한비뇨기과학회지 2015년 56권 2호 p.125 ~ 130
 ( Chung Eric ) - University of Queensland Princess Alexandra Hospital Department of Urology

 ( Yang Sun ) - University of Queensland Princess Alexandra Hospital Department of Urology
 ( White Louise ) - University of Queensland Princess Alexandra Hospital Department of Urology
 ( Wood Simon ) - University of Queensland Princess Alexandra Hospital Department of Urology
 ( Nicol David ) - Royal Marsden Hospital Department of Urology

Abstract


Purpose

To report on lessons learnt in the management of primary invasive penile cancer in a major tertiary hospital in Australia.

Materials and Methods

Medical records for all patients who underwent surgery for primary invasive penile cancer between January 2000 and January 2011 were obtained. Patient demographics, clinical status of inguinal node, cancer stage and clinical outcomes were reviewed. All patients were followed up for a minimum of 48 months postoperative unless patient deceased within the first 48 months from the time of penile cancer surgery.

Results

Over the 11-year period, a total of 23 cases of invasive penile cancer were identified. Partial penectomy was the most common form of organ preserving surgery and the majority of patients have pT1b disease. Of the 9 patients with clinically palpable inguinal nodes, 7 patients were diagnosed with pN3 disease following inguinal lymphadenectomy. The Kaplan-Meier cancer-specific survival at 72 months showed decreasing survival based on tumour stage (83% in pT1, 79% in pT2, and 64% in pT3 disease) and nodal disease (100% in node negative, 50% in superficial inguinal lymphadenopathy, and 38% in patients with deep inguinal and/or pelvic lymphadenopathy) (p=0.082). The Kaplan-Meier cancer-specific survival revealed statistically significant difference in survival outcome in patients with local recurrence vs. systemic metastasis disease (33% vs. 17%, p=0.008).

Conclusions: The presence of high risk features such as tumour stage, lymph node involvement and distant metastasis carries a significant higher risk of death and tumour recurrence in patients with penile cancer and inguinal lymph node metastasis.

키워드

Penile neoplasms; Survival; Treatment outcome
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