Oncological outcomes in the management of cT1-T2 cN0 penile squamous cell carcinoma

  • Juan Garisto Department of Urology, Veteran Affairs Boston Healthcare System, Boston, Massachusetts
  • Madhur Nayan Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Kamel Fadaak Department of Urology, College of Medicine, King Fahd Hospital of the University, Saudi Arabia
  • Kathy Li Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Advait Pandya Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Ricardo Leao Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Peter Chung Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Srikala S. Shridar Division of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Joelle Helou Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
  • Girish S. Kulkarni Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto
Keywords: partial penectomy, brachytherapy, penile cancer , squamous cell carcinoma

Abstract

Introduction: Squamous cell carcinoma (SCC) of the penis is a rare disease comprising 1% of all male cancer. Options for the management of cT1-T2 cN0 penile SCC include partial penectomy (PP), considered the standard, and brachytherapy (BT), which offers acceptable local disease control and organ preservation. The purpose of our study was to assess and describe the oncological outcome for both treatments in a tertiary care center.

Methods: We performed a contemporary retrospective study of patients with early-stage penile cancer treated surgically or by BT at a tertiary center between 2000 and 2016. Demographic, management, and followup data were obtained from an institutional database. Descriptive statistics and survival analysis using Kaplan- Meier plots were calculated. Local and regional recurrences were compared in both groups (BT vs. PP).

Results: A total of 51 patients with cT1-T2N0 penile SCC treated with BT (35) and PP (16) were analyzed. Median followup was 37.1 (13.9–68) and 25.4 months (18–52.3) for the BT and PP groups, respectively. Recurrence developed in seven (20%) patients treated with BT. Median time to recurrence was 35.2 months (range 2.9– 95.8). No recurrences were reported in patients treated with PP. Forty-four (86.2%) patients were alive with no evidence of disease at the last followup. Overall survival was 62.7%. Complications after primary tumor treatment were urethral stenosis (15.7%), penile necrosis (7.8%), and local infection (2%).

Conclusions: PP provides acceptable local control with organ preservation in early-stage penile SCC. BT was able to offer organ preservation in 69% of men. Future prospective studies are needed to compare other organ-conserving treatment modalities with PP.

Published
2020-11-17
How to Cite
Garisto, J., Nayan, M., Fadaak, K., Li, K., Pandya, A., Leao, R., Chung, P., Shridar, S. S., Helou, J., & Kulkarni, G. S. (2020). Oncological outcomes in the management of cT1-T2 cN0 penile squamous cell carcinoma. Canadian Urological Association Journal, 15(6), 187-91. https://doi.org/10.5489/cuaj.6762
Section
Original Research