OBJECTIVE: 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.
METHODS: 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 P ≤ 0.05.
RESULTS: 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% (n = 19), these patients are all disease free to date. Disease-specific survival was 85% at 10 years. Penile cancer related mortality was 8% (n = 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% (n = 16) of cases with 44% (n = 7) of these patients requiring concurrent bilateral pelvic lymph node dissection. Fifty percent (n = 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 (n = 8) of patients received chemotherapy.
CONCLUSIONS: 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.
Written by:
Breen KJ, O'Connor KM, Power DG, Mayer NJ, Rogers E, Sweeney P. Are you the author?
Department of Urology, Mercy University Hospital, Cork, Ireland; Department of Oncology, Mercy University Hospital, Cork, Ireland; Department of Pathology, Cork University Hospital, Cork, Ireland.
Reference: Surgeon. 2014 Feb 18. pii: S1479-666X(14)00013-4.
doi: 10.1016/j.surge.2014.01.007
PubMed Abstract
PMID: 24559898
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