Intermediate-differentiated invasive (pT1 G2) penile cancer--oncological outcome and follow-up.
OBJECTIVE
Due to the low prevalence of penile cancer, little evidence exists on the metastatic potential and the ideal treatment strategies in intermediate-differentiated invasive (pT1 G2) penile cancer. The current study aimed to analyze the oncologic outcome of patients with penile carcinoma with long-term follow-up in a single-center study.


METHODS
In this retrospective study, 38 patients with histologically proven T1 G2 squamous cell carcinoma of the penis were included. Only the 'classic' subtype was analyzed. Treatment of the primary tumor was Nd:YAG laser-therapy, excision, or partial amputation. Follow-up was performed according to EAU guidelines (2004).


RESULTS
Mean follow-up was 78.1 months (range: 9-285 months). Local recurrence was seen in 12 patients (31.6%), but was not correlated with disease related death (P = 0.7944). Rate of local recurrence was not dependent on treatment modality (P = 0.3481); 13 patients died, accounting for a disease related survival rate of 81.6% during observation period. Positive lymph nodes were seen in 28.9% of patients and were significantly correlated with disease related death (P = 0.00004). Clinically enlarged inguinal lymph nodes were not correlated with histologically confirmed positive lymph nodes (P = 0.5785).


CONCLUSIONS
For patients with T1 G2 penile cancer, organ preserving therapy appears to be a suitable treatment option. In our series, nearly one third of patients developed inguinal lymph node metastases, which highlights the potential benefit of surgical staging. Larger prospective multicenter studies are needed to define the best treatment strategy for intermediate-differentiated invasive penile cancer.
Schlenker
Boris
B
Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany. boris.schlenker@med.uni-muenchen.de
Tilki
Derya
D
Gratzke
Christian
C
Seitz
Michael
M
Reich
Oliver
O
Schneede
Peter
P
Stief
Christian G
CG
Hungerhuber
Edwin
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D002454:Cell Differentiation; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D013521:Urologic Surgical Procedures, Male