title: Lessons learnt in the management of primary invasive penile cancer in an Australian tertiary referral centre: clinical outcomes with a minimum 48 months follow-up study.
abstract: OBJECTIVE
  To report on lessons learnt in the management of primary invasive penile cancer in a major tertiary hospital in Australia.
  
  
  METHODS
  Medical records for all patients who underwent surgery for primary invasive penile cancer between January 2000 and January 2011 were obtained. Patient demographics, clinical status of inguinal node, cancer stage and clinical outcomes were reviewed. All patients were followed up for a minimum of 48 months postoperative unless patient deceased within the first 48 months from the time of penile cancer surgery.
  
  
  RESULTS
  Over the 11-year period, a total of 23 cases of invasive penile cancer were identified. Partial penectomy was the most common form of organ preserving surgery and the majority of patients have pT1b disease. Of the 9 patients with clinically palpable inguinal nodes, 7 patients were diagnosed with pN3 disease following inguinal lymphadenectomy. The Kaplan-Meier cancer-specific survival at 72 months showed decreasing survival based on tumour stage (83% in pT1, 79% in pT2, and 64% in pT3 disease) and nodal disease (100% in node negative, 50% in superficial inguinal lymphadenopathy, and 38% in patients with deep inguinal and/or pelvic lymphadenopathy) (p=0.082). The Kaplan-Meier cancer-specific survival revealed statistically significant difference in survival outcome in patients with local recurrence vs. systemic metastasis disease (33% vs. 17%, p=0.008).
  
  
  CONCLUSIONS
  The presence of high risk features such as tumour stage, lymph node involvement and distant metastasis carries a significant higher risk of death and tumour recurrence in patients with penile cancer and inguinal lymph node metastasis.
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, Australia. ; Department of Surgery, University of Queensland, Brisbane, Australia.
authors: Eric
authors: E
authors: Chung
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, Australia. ; Department of Urology, The Royal Marsden Hospital, London, UK.
authors: Sun
authors: S
authors: Yang
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, Australia.
authors: Louise
authors: L
authors: White
authors: Department of Urology, Princess Alexandra Hospital, Brisbane, Australia.
authors: Simon
authors: S
authors: Wood
authors: Department of Urology, The Royal Marsden Hospital, London, UK.
authors: David
authors: D
authors: Nicol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Penile neoplasms; Survival; Treatment outcome