Penile cancer – Guideline adherence produces optimum results. Issue 4 (August 2015)

• Record Type: Journal Article
• Authors: Breen, K.J.; O'Connor, K.M.; Power, D.G.; Mayer, N.J.; Rogers, E.; Sweeney, P.
• Is Part Of: Surgeon. Volume 13:Issue 4(2015)
• Page Start: 200
• Page End: 206
• Publication Date: 2015-08
• Subjects: Surgery -- Periodicals; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617
• DOI: 10.1016/j.surge.2014.01.007
• Languages: English
• ISSNs: 1479-666X

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Objective</title> <p id="abspara0010">To audit the management and outcome of penile cancer in a tertiary university teaching hospital, comparing our results to international best practice and published guidelines.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">The Hospital Inpatient Enquiry database of the Mercy University Hospital was interrogated for penile cancer patients treated between 2001 and 2012. Data relating to presentation, local treatment, histology, lymph-node management, outcome and survival was recorded. Data were analysed using the Log Rank test, with significance defined as <italic>P</italic> ≤ 0.05.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Twenty-five patients were identified with a median age of 61 years. The majority of cases at presentation were ≥T2 (54%) and intermediate to high grade (76%). The median follow-up of patients was 3.75 years (range 9 months–10 years). Overall survival was 76% (<italic>n</italic> = 19), these patients are all disease free to date. Disease-specific survival was 85% at 10 years. Penile cancer related mortality was 8% (<italic>n</italic> = 2), 4 patients (16%) died of non-penile cancer related causes. Twenty-two patients (88%) had surgery and 3 patients (12%) had radiotherapy. Based on EAU guidelines inguinal lymph node dissection (ILND) was performed in 64% (<italic>n</italic> = 16) of cases with 44% (<italic>n</italic> = 7) of these patients requiring concurrent bilateral pelvic lymph node dissection. Fifty percent (<italic>n</italic> = 8) of ILNDs showed metastatic disease. Ten year disease-specific survival for node negative versus node positive disease is 100% versus 57%. Thirty-two percent (<italic>n</italic> = 8) of patients received chemotherapy.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Penile cancer is a rare oncological condition that often requires bilateral inguinal ± pelvic lymph node dissection and should be managed according to published guidelines, in specialist centres in order to maximize outcomes.</p> </sec> </abstract>