Penile cancer (PeCa) is a rare disease. HPV infection, smoking, phimosis, and lichen sclerosus represent well-known associated risk factors.
Primary aim of our study is to evaluate the incidence and risk factors of PeCa and to outline the adopted diagnostic and therapeutic approaches. Secondary aim is to investigate risk factors associated with aggressive disease and to identify the complications arising from its surgical treatment.
We conducted a retrospective analysis using the PearlDiver™ Mariner database, from January 1, 2011, to December 31, 2021, identifying all patients diagnosed with PeCa and PeIN, evaluating comorbidities, risk factors, and social and economic conditions. We evaluated the imaging modalities employed for staging as well as the treatment strategies. Finally, we evaluated the most frequent complications associated with inguinal lymphadenectomy (ILND).
During the study period, 17,494 patients were diagnosed with PeCa and 5,965 with penile intraepithelial neoplasia (PeIN). US was the most frequently utilized imaging modality, followed by PET and PET/CT. Use of CT and MRI was around 5%. Surgical treatment was the predominant strategy, utilized in 31.3% of PeCa and 22.9% of PeIN. Wide Local Excision/Glansectomy emerged as the most common surgical procedures. MLR analysis identified smoking as a risk factor for metastatic PeCa (OR; 95% CI = 1.49; 1.379-1.609), HPV infections were associated with a 35% decrease in risk (OR; 95% CI = 0.65; 0.562-0.744) (all P < 0.001). Lichen sclerosus and phimosis were associated with a doubled risk of demolitive surgery. Approximately 40% of patients experienced complications associated with ILND.
Despite advances in PeCa management, there's no significant move toward more conservative treatments. Surgical treatments are still marked by high rates of complications, potentially affect the sexual and psychosocial health of patients. These issues may foster a tendency toward avoidance behaviors, contributing to a delayed clinical presentation and treatment.
Urologic oncology. 2024 Jun 28 [Epub ahead of print]
Eugenio Bologna, Leslie Claire Licari, Antonio Franco, Francesco Ditonno, Celeste Manfredi, Cosimo De Nunzio, Sisto Perdona, Aldo Brassetti, Costantino Leonardo, Christopher L Coogan, Edward E Cherullo, Riccardo Autorino
Department of Urology, Rush University, Chicago, IL, USA; Department of Maternal-Child and Urological Sciences, Sapienza University Rome, Policlinico Umberto I Hospital, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA; Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA; Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, Italy., Department of Urology, Rush University, Chicago, IL, USA; Department of Woman, Unit of Urology, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy., Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy., Department of Urology, Rush University, Chicago, IL, USA., Department of Urology, Rush University, Chicago, IL, USA. Electronic address: .