Penile cancer is highly prevalent in low- and middle-income countries, with significant morbidity and mortality rates. The first Brazilian consensus provides support to improve penile cancer patients' outcomes, based on expert's opinion and evidence from medical literature.
Fifty-one Brazilian experts (clinical oncologists, radiation oncologists, urologists, and pathologists) assembled and voted 104 multiple-choice questions, confronted the results with the literature, and ranked the levels of evidence.
Healthcare professionals need to deliver more effective communication about the risk factors for penile cancer. Staging and follow-up of patients include physical examination, computed tomography, and magnetic resonance imaging. Close monitoring is crucial, because most recurrences occur in the first 2-5 years. Lymph-node involvement is the most important predictive factor for survival, and management depends on the location (inguinal or pelvic) and the number of lymph nodes involved. Conservative treatment may be helpful in selected patients without compromising oncological outcomes; however, surgery yields the lowest rate of local recurrence.
This consensus provides an essential decision-making orientation regarding this challenging disease.
Journal of cancer research and clinical oncology. 2020 Oct 26 [Epub ahead of print]
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
Department of Oncology, Centro Paulista de Oncologia-Oncoclínicas, Av. Brigadeiro Faria Lima, 4300, Vila Olímpia, São Paulo, SP, 01452-000, Brazil. ., Department of Radiotherapy, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil., Department of Urology, Hospital Ophir Loyola, Belém, Pará, Brazil., Department of Oncology, Hospital Universitário da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil., Department of Radiotherapy, Hospital Haroldo Juaçaba, Fortaleza, Ceará, Brazil., Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil., Department of Oncology, Hospital Haroldo Juaçaba, Fortaleza, Ceará, Brazil., Medical Research Laboratory of the Discipline of Urology, Faculdade de Medicina da USP, São Paulo, São Paulo, Brazil., Department of Urology, Santa Casa de Misericórdia de Maceió, Maceió, Alagoas, Brazil., Department of Urology, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil., Department of Urology, Hospital Universitário Presidente Dutra, UFMA, São Luís, Maranhão, Brazil.