What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes
Context: The primary lesion in penile cancer is managed by surgery or radiation. Surgical options include penile-sparing surgery, amputative surgery, laser excision, and Moh’s micrographic surgery. Radiation is applied as external beam radiotherapy (EBRT) and brachytherapy. The treatment aims to com...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | European Urology Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168322000775 |
| _version_ | 1811250448029450240 |
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| author | Vasileios I. Sakalis Riccardo Campi Lenka Barreto Herney Andres Garcia-Perdomo Isabella Greco Łukasz Zapala Mithun Kailavasan Tiago Antunes-Lopes Jack David Marcus Kenneth Manzie John Osborne Benjamin Ayres Luc M.F. Moonen Andrea Necchi Juanita Crook Pedro Oliveira Lance C. Pagliaro Chris Protzel Arie S. Parnham Maarten Albersen Curtis A. Pettaway Philippe E. Spiess Scott T. Tagawa R. Bryan Rumble Oscar R. Brouwer |
| author_facet | Vasileios I. Sakalis Riccardo Campi Lenka Barreto Herney Andres Garcia-Perdomo Isabella Greco Łukasz Zapala Mithun Kailavasan Tiago Antunes-Lopes Jack David Marcus Kenneth Manzie John Osborne Benjamin Ayres Luc M.F. Moonen Andrea Necchi Juanita Crook Pedro Oliveira Lance C. Pagliaro Chris Protzel Arie S. Parnham Maarten Albersen Curtis A. Pettaway Philippe E. Spiess Scott T. Tagawa R. Bryan Rumble Oscar R. Brouwer |
| author_sort | Vasileios I. Sakalis |
| collection | DOAJ |
| description | Context: The primary lesion in penile cancer is managed by surgery or radiation. Surgical options include penile-sparing surgery, amputative surgery, laser excision, and Moh’s micrographic surgery. Radiation is applied as external beam radiotherapy (EBRT) and brachytherapy. The treatment aims to completely remove the primary lesion and preserve a sufficient functional penile stump. Objective: To assess whether the 5-yr recurrence-free rate and other outcomes, such as sexual function, quality of life, urination, and penile preserving length, vary between various treatment options. Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane HTA, DARE, HEED), Google Scholar, and ClinicalTrials.gov were searched for publications from 1990 through May 2021. Randomized controlled trials, nonrandomized comparative studies (NRCSs), and case series (CSs) were included. Evidence synthesis: The systematic review included 88 studies, involving 9578 men from 16 NRCSs and 72 CSs. The cumulative mean 5-yr recurrence-free rates were 82.0% for penile-sparing surgery, 83.9% for amputative surgery, 78.6% for brachytherapy, 55.2% for EBRT, 69.4% for lasers, and 88.2% for Moh’s micrographic surgery, as reported from CSs, and 76.7% for penile-sparing surgery and 93.3% for amputative surgery, as reported from NRCSs. Penile surgery affects sexual function, but amputative surgery causes more appearance concerns. After brachytherapy, 25% of patients reported sexual dysfunction. Both penile-sparing surgery and amputative surgery affect all aspects of psychosocial well-being. Conclusions: Despite the poor quality of evidence, data suggest that penile-sparing surgery is not inferior to amputative surgery in terms of recurrence rates in selected patients. Based on the available information, however, broadly applicable recommendations cannot be made; appropriate patient selection accounts for the relative success of all the available methods. Patient summary: We reviewed the evidence of various techniques to treat penile tumor and assessed their effectiveness in oncologic control and their functional outcomes. Penile-sparing as well as amputative surgery is an effective treatment option, but amputative surgery has a negative impact on sexual function. Penile-sparing surgery and radiotherapy are associated with a higher risk of local recurrence, but preserve sexual function and quality of life better. Laser and Moh’s micrographic surgery could be used for smaller lesions. |
| first_indexed | 2024-04-12T16:04:49Z |
| format | Article |
| id | doaj.art-eae707e7a6c14b7388c00120c232c7cd |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-12T16:04:49Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-eae707e7a6c14b7388c00120c232c7cd2022-12-22T03:26:06ZengElsevierEuropean Urology Open Science2666-16832022-06-01405894What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their OutcomesVasileios I. Sakalis0Riccardo Campi1Lenka Barreto2Herney Andres Garcia-Perdomo3Isabella Greco4Łukasz Zapala5Mithun Kailavasan6Tiago Antunes-Lopes7Jack David Marcus8Kenneth Manzie9John Osborne10Benjamin Ayres11Luc M.F. Moonen12Andrea Necchi13Juanita Crook14Pedro Oliveira15Lance C. Pagliaro16Chris Protzel17Arie S. Parnham18Maarten Albersen19Curtis A. Pettaway20Philippe E. Spiess21Scott T. Tagawa22R. Bryan Rumble23Oscar R. Brouwer24Department of Urology, Agios Pavlos General Hospital, Thessaloniki, Greece; Corresponding author. Department of Urology, Agios Pavlos General Hospital, Ethnikis Antistaeos 161, Kalamaria, Thessaloniki, Greece. Tel. +302313 304 545.Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, San Luca Nuovo, Florence, ItalyDepartment of Urology, University Hospital Nitra, Nitra, SlovakiaDivision of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad Del Valle, Cali, ColombiaDepartment of Urological Minimally Invasive and Robotic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, ItalyDepartment of Urology, Medical University of Warsaw, Warsaw, PolandRoyal Derby Hospital, Derby, UKDepartment of Urology, Hospital de S. João, Porto, PortugalMulticancer Fighter Patient Advocate, Us TOO, New York, NY, USAPatient Advocate, ORCHID, UKPatient Advocate, ORCHID, UKDepartment of Urology, St George's University Hospitals NHS Foundation Trust, London, UKDepartment of Radiotherapy, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsDepartment of Urology and Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyUniversity of British Columbia, British Columbia Cancer Agency, Kelowna, British Columbia, CanadaDepartment of Urology, The Christie NHS Foundation Trust, Manchester, UK; Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, UTAD, Vila Real, Portugal; Veterinary Sciences Department, University of Trás-os-Montes and Alto Douro, UTAD, Vila Real, PortugalDepartment of Oncology, Mayo Clinic, Rochester, MN, USAHelios Clinics Schwerin, Schwerin, GermanyDepartment of Urology, The Christie NHS Foundation Trust, Manchester, UKDepartment of Urology, University Hospitals Leuven, Leuven, BelgiumThe University of Texas MD Anderson Cancer Center, Houston, TX, USADepartment of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USADivision of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USAAmerican Society of Clinical Oncology, Alexandria, VA, USAThe Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsContext: The primary lesion in penile cancer is managed by surgery or radiation. Surgical options include penile-sparing surgery, amputative surgery, laser excision, and Moh’s micrographic surgery. Radiation is applied as external beam radiotherapy (EBRT) and brachytherapy. The treatment aims to completely remove the primary lesion and preserve a sufficient functional penile stump. Objective: To assess whether the 5-yr recurrence-free rate and other outcomes, such as sexual function, quality of life, urination, and penile preserving length, vary between various treatment options. Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane HTA, DARE, HEED), Google Scholar, and ClinicalTrials.gov were searched for publications from 1990 through May 2021. Randomized controlled trials, nonrandomized comparative studies (NRCSs), and case series (CSs) were included. Evidence synthesis: The systematic review included 88 studies, involving 9578 men from 16 NRCSs and 72 CSs. The cumulative mean 5-yr recurrence-free rates were 82.0% for penile-sparing surgery, 83.9% for amputative surgery, 78.6% for brachytherapy, 55.2% for EBRT, 69.4% for lasers, and 88.2% for Moh’s micrographic surgery, as reported from CSs, and 76.7% for penile-sparing surgery and 93.3% for amputative surgery, as reported from NRCSs. Penile surgery affects sexual function, but amputative surgery causes more appearance concerns. After brachytherapy, 25% of patients reported sexual dysfunction. Both penile-sparing surgery and amputative surgery affect all aspects of psychosocial well-being. Conclusions: Despite the poor quality of evidence, data suggest that penile-sparing surgery is not inferior to amputative surgery in terms of recurrence rates in selected patients. Based on the available information, however, broadly applicable recommendations cannot be made; appropriate patient selection accounts for the relative success of all the available methods. Patient summary: We reviewed the evidence of various techniques to treat penile tumor and assessed their effectiveness in oncologic control and their functional outcomes. Penile-sparing as well as amputative surgery is an effective treatment option, but amputative surgery has a negative impact on sexual function. Penile-sparing surgery and radiotherapy are associated with a higher risk of local recurrence, but preserve sexual function and quality of life better. Laser and Moh’s micrographic surgery could be used for smaller lesions.http://www.sciencedirect.com/science/article/pii/S2666168322000775Penile cancerSurgeryPenile sparingAmputationLaserMoh’s micrographic surgery |
| spellingShingle | Vasileios I. Sakalis Riccardo Campi Lenka Barreto Herney Andres Garcia-Perdomo Isabella Greco Łukasz Zapala Mithun Kailavasan Tiago Antunes-Lopes Jack David Marcus Kenneth Manzie John Osborne Benjamin Ayres Luc M.F. Moonen Andrea Necchi Juanita Crook Pedro Oliveira Lance C. Pagliaro Chris Protzel Arie S. Parnham Maarten Albersen Curtis A. Pettaway Philippe E. Spiess Scott T. Tagawa R. Bryan Rumble Oscar R. Brouwer What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes European Urology Open Science Penile cancer Surgery Penile sparing Amputation Laser Moh’s micrographic surgery |
| title | What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes |
| title_full | What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes |
| title_fullStr | What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes |
| title_full_unstemmed | What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes |
| title_short | What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes |
| title_sort | what is the most effective management of the primary tumor in men with invasive penile cancer a systematic review of the available treatment options and their outcomes |
| topic | Penile cancer Surgery Penile sparing Amputation Laser Moh’s micrographic surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2666168322000775 |
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