Epidemiological aspects of penile cancer in Rio de Janeiro: evaluation of 230 cases

Abstract

Purpose: To determine epidemiological characteristics of penile cancer in Rio de Janeiro, its associated risk factors and clinical manifestations. Patients and Methods: Between 2002 and 2008 we evaluated 230 patients at three public institutions, considering age, ethnicity, birthplace, marital status, educational level, religion, tobacco smoking, presence of phimosis and practice of circumcision. Results: The ages ranged from 25 to 98 years, with an average of 58.35 years. Of the 230 patients, 167 (72.7%) were from the southeast region of Brazil (which includes Rio de Janeiro) and 45 (19.5%) were from the northeast of the country. Most patients were white (67.3%), married (58.6%), smokers (56.5%) and had not completed primary school (71.3%). The predominant religion was Catholic (74.8%). Of the 46 (20%) circumcised patients, only 1 (2.2%) had undergone neonatal circumcision. Grade I tumors were present in 87 (37.8%) of the patients, grade II in 131 (56.9%) and grade III in 12 (5.3%). Lymphovascular embolization was observed in 63 (27.3%) and koilocytosis in 124 (53.9%) patients. Of the total, 41.3% had corpora cavernosa or corpus spongiosum infiltration, and 40 (17.4%) had urethral invasion. Prophylactic lymphadenectomy was performed on 56 (36.1%), therapeutic lymphadenectomy on 84 (54.2%) and hygienic lymphadenectomy for advanced disease on 15 (9.7%) patients. The median time between the lesion onset and clinical diagnosis was 13.2 months. The mean follow up was 28.8 months. Conclusion: Most of our patients were born in this state and had low socioeconomic status. Most of them were white men, married, smokers, uncircumcised, of the Catholic faith and in their sixties or older. Their disease was in most cases diagnosed only in the advanced stages.

Prevalence of human papillomavirus in penile malignant tumors: viral genotyping and clinical aspects

“…The average age of the patients at diagnosis predominates in advanced age (>50 years), which suggests that men seek health services very late in life [15]. Younger individuals are also affected, but in smaller percentages [7].…”

“…Koifman et al [15] reported the presence of invasion of the spongiosum or cavernous corpus in 41.3% of the patients.…”

The Impact of Human Papillomavirus on Cancer Risk in Penile Cancer

“…Several studies have confirmed a predominance of penile cancer in the North and Northeast of Brazil which are regions with lower human development indexes (Favorito et al, 2008;Koifman et al, 2011;Reis et al, 2010a). Scheiner et al (2008) in Rio de Janeiro, Brazil found that HPV infection may have contributed to malignant transformation in a large proportion of their penile cancer cases but only inguinal metastasis was a prognostic factor impacting survival of those patients.…”

“…Koifman (2011) reported that penile cancer was more prevalent in patients born in the state of Rio de Janeiro. According to the data from the Brazilian Ministry of Health, there is an estimated 850 partial or complete penile surgical procedures performed in the context of malignancy yearly within Brazil, with approximately 50% of these procedures being performed in the North and Northeast regions of the country (Favorito et al, 2008).…”

Human Papillomavirus and Related Diseases - From Bench to Bedside - A Clinical Perspective

“…In a case control study in Denmark, of the 37 penile SCC patients whose tumor tissues were PCRexamined for the presence of HPV DNA, 24 (65%) were high-risk HPV positive, and 1 (3%) was positive to a low-risk HPV type (HPV 6) [Madsen et al, 2008]. Several studies have confirmed a predominance of penile cancer in the North and Northeast of Brazil which are regions with lower human development indexes (Favorito et al, 2008;Koifman et al, 2011;Reis et al, 2010a). Scheiner et al (2008) in Rio de Janeiro, Brazil found that HPV infection may have contributed to malignant transformation in a large proportion of their penile cancer cases but only inguinal metastasis was a prognostic factor impacting survival of those patients.…”