Penile cancer is rare, with significant morbidity and limited literature assessing utility of peripheral and deep en face margin assessment (PDEMA) versus traditional margin assessment (vertical sections) on treatment outcomes.
32-year Retrospective Multicenter Cohort Study at 3 academic tertiary care centers. Cohort of 189 patients with histologic diagnosis of in situ or T1a cutaneous squamous cell carcinoma of the penis at Brigham and Women's, Massachusetts General Hospital (1988-2020), and Memorial Sloan Kettering Cancer Center (1995-2020) treated with PDEMA surgical excision, excision/circumcision, or penectomy/glansectomy. Local recurrence, metastasis, and disease-specific death were assessed via multivariable Cox proportional hazard models.
The cohort consisted of 189 patients. Median age at diagnosis was 62 years. Median tumor diameter was 1.3 centimeters. The following outcomes of interest occurred: 30 local recurrences, 13 metastases, and 5 disease-specific deaths. Primary tumors were excised with PDEMA (N = 30), excision/circumcision (N = 110), or penectomy/glansectomy (N = 49). Of patients treated with traditional margin assessment (non-PDEMA), 12% had narrow or positive margins. 5-year proportions were as follows with respect to local recurrence-free survival (LRFS), metastasis-free survival (MFS), and disease-specific survival/progression-free survival (DSS/PFS), respectively: 100%, 100%, 100% following PDEMA; 82%, 96%, 99% following excision/circumcision; 83%, 91%, 95% following penectomy/glansectomy.
multi-institutional cohort study not externally validated.
Initial results are encouraging that PDEMA surgical management effectively controls early-stage penile squamous cell carcinoma.
The Journal of urology. 2023 Oct 03 [Epub ahead of print]
Katie A O'Connell, Jacob L Thomas, Fadi Murad, Guohai Zhou, Guru P Sonpavde, Matthew Mossanen, Timothy N Clinton, Antonio Ji-Xu, Kristina Alton, Philippe E Spiess, Anthony M Rossi, Chrysalyne D Schmults
Brigham & Women's/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Division of Dermatology, Memorial Sloan Kettering Cancer Center, New York, New York., Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts., AdventHealth Cancer Institute, Orlando, Florida., Division of Urology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Department of Dermatology, University of California, Davis, School of Medicine, Sacramento, California., Department of Psychiatry and Behavioral Neurosciences, Vanderbilt University Medical Center, Nashville, Tennessee., Moffitt Cancer Center, Tampa, Florida.