Advancements in staging and imaging for penile cancer

Ottenhof, Sarah R.; Leone, Andrew; Horenblas, Simon; Spiess, Philippe E.; Vegt, Erik

doi:10.1097/mou.0000000000000447

Cited by 13 publications

(4 citation statements)

References 67 publications

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“…Although, our diagnostic evaluation including US‐guided FNA followed by DSNB showed a low number of false negatives, further improvements of this diagnostic workflow should be explored. For example repeated FNA in men with palpable LNs, which would allow timely ILN dissection and avoid DNSB because of false negative US‐guided FNA results [19]. An additional interesting research approach represents radiomics using US [20] or cross‐sectional images [21].…”

Section: Discussionmentioning

confidence: 99%

High diagnostic accuracy of inguinal ultrasonography and fine‐needle aspiration followed by dynamic sentinel lymph node biopsy in men with impalpable and palpable inguinal lymph nodes

et al. 2022

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To assess the accuracy of dynamic sentinel lymph node biopsy (DSNB) after negative ultrasonography (US) guided fineneedle aspiration (FNA) for inguinal lymph node (ILN) staging. Patients and MethodsWe performed a retrospective analysis of men with ≥T1G2 penile cancer and negative inguinal US-guided FNA undergoing DSNB. Men with suspicious US but negative FNA underwent US-guided ILN excision. Men with ≥T1G2 local recurrence during follow-up and non-squamous cell histologies were excluded. Descriptive analysis was performed, and sensitivity and negative predictive values (NPVs) were calculated. ResultsWe included 403 men with 728 groins with negative FNA undergoing DSNB AE US-guided LN excision. At least one sentinel LN (SN) was visualised in 93% during the first and in 7% during the second lymphoscintigraphy. The median SNs visualised preoperatively was 1 SN and a median of 2 LNs were resected. ILN metastases were detected in 9% groins in men with impalpable and in 17% men with palpable LNs. Stratified by impalpable and palpable ILN, non-local recurrence despite pathologically negative DSNBs was seen in 0.5% and 0%, respectively. Limited to men with ≥24 months follow-up, non-local recurrence after negative DSNBs was seen in 0.4% and 0%, respectively. The sensitivity of DSNB was 96% and the NPV was 100%. The main limitation of this analysis is its retrospective nature with inherit biases. ConclusionsInguinal US and FNA followed by DSNB can accurately stage men with both impalpable and palpable ILN, which provides logistical and surgical advantages.

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Section: Discussionmentioning

confidence: 99%

High diagnostic accuracy of inguinal ultrasonography and fine‐needle aspiration followed by dynamic sentinel lymph node biopsy in men with impalpable and palpable inguinal lymph nodes

et al. 2022

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“…Previous study showed a very high accuracy (up to 93%) of MRI for clinical nodal staging to predict pathological LN involvement (11) and the use of pelvic MRI to assess the local extent of tumor and regional LN enlargement is highly recommended in the current guidelines (6). In contrast, a recent meta-analysis reported an only 57% sensitivity of PET/CT in detecting LN metastasis in clinically negative groin, and using PET/ CT in patients with distal urethral SCC with clinically negative groins was not recommended (15,16). In the current study, a false positive result was shown on PET/CT, probably indicating a potentially unsatisfactory specificity of PET/CT.…”

Section: Discussionmentioning

confidence: 99%

Transperineal-incision urethrectomy combined with laparoscopic prostatectomy for a male patient with squamous cell carcinoma involving distal plus proximal urethra and untypical symptoms—a case report

Wang¹,

Yang²,

Wu³

et al. 2021

Transl Androl Urol

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Primary urethral carcinoma (PUC) is a rare malignancy, covering less than 1% of all genitourinary cancers. Different tumor location, classified as tumor in distal or proximal urethra, represents different characteristics and often leads to different treatment modality. However, data on the surgical approach for PUC involving both distal and proximal urethra remains rare. In this case, we presented a 75-year-old man with untypical symptoms of perineal mass and unspecific frequent and painful urination.Results of multiparametric magnetic resonance imaging (mp-MRI), positron emission tomography/computed tomography (PET/CT) scan, and percutaneous biopsy revealed a cT2N1M0 PUC involving both distal and proximal urethra. Given the request of patients for a normal penile appearance after surgery, a transperinealincision urethrectomy combined with laparoscopic prostatectomy and iliac lymphadenectomy was performed with optimal outcomes. The results of histopathological analysis revealed a moderately-high differentiated PUC with no positive lymph node. Post-operative recovery was uneventful. On first visit 1-month after surgery, physical examination revealed a satisfactory wound healing and appearance of penis and no recurrent lesions were found on mp-MRI. This is a rare case with untypical symptoms indicating that patients with PUC involving both distal and proximal urethra may present with no symptoms of urethral stricture but only non-specific lower urinary symptoms. The surgical approach we proposed in this case proves to be a safe and feasible one to completely resect the tumor and preserve a normal appearance of penis, thus worth to be applied in the specific patient population.

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“…Imaging can also help to identify metastatic disease or other affected lymph nodes in the chest, abdomen, or pelvis. 50 It is important to note that imaging is a useful adjunct to physical examination. Indeed, as much as 16% of patients without palpable lymphadenopathy may harbor occult metastatic disease, and 20–40% of patients with palpable lymphadenopathy are found to be non-metastatic.…”

Section: Imaging For Nodal and Metastatic Diseasementioning

confidence: 99%

Therapeutic Approaches to Penile Cancer: Standards of Care and Recent Developments

White,

Mason,

Lawen

et al. 2023

RRU

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Penile cancer is a rare malignancy, most commonly diagnosed in older men, associated with poor outcomes, dramatic decline in quality of life and sexual function. Squamous cell carcinoma is the most common histopathology of penile cancer, accounting for 95% of all cases. Localized, early-stage penile cancer can be effectively managed through penile-sparing techniques in many cases, though advanced stages of penile cancer carry a poor prognosis. Current innovative treatments are exploring the role of targeted therapy, HPV-directed therapy, immune checkpoint inhibitors and adoptive T-cell therapies in treatment and prevention of relapse of penile cancer. Clinical trials are investigating the potential of targeted therapies and immune checkpoint inhibitors in advanced penile cancer. This review examines the current management of penile cancer and highlights future directions in research and treatment.

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Advancements in staging and imaging for penile cancer

Abstract: Over the past decade, staging and treatment of penile cancer have become less invasive, while survival tends to improve.

Cited by 13 publications

References 67 publications

High diagnostic accuracy of inguinal ultrasonography and fine‐needle aspiration followed by dynamic sentinel lymph node biopsy in men with impalpable and palpable inguinal lymph nodes

High diagnostic accuracy of inguinal ultrasonography and fine‐needle aspiration followed by dynamic sentinel lymph node biopsy in men with impalpable and palpable inguinal lymph nodes

Transperineal-incision urethrectomy combined with laparoscopic prostatectomy for a male patient with squamous cell carcinoma involving distal plus proximal urethra and untypical symptoms—a case report

Therapeutic Approaches to Penile Cancer: Standards of Care and Recent Developments

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