Penile cancer in Scandinavia: Current practice and future perspectives

Jakobsen, John; Krarup, Kim Predbjørn; Kirrander, Peter; Håkansson, Ulf; Kaipia, Antti; Perttilä, Ilkka; Axcrona, Karol; Torkelsen, T.; Hilmarsson, Rafn; Jensen, Jørgen Bjerggaard

doi:10.3109/21681805.2014.987316

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…From April 2010 in Centre one and from January 2013 in Centre two, we prospectively enrolled patients diagnosed with invasive PSCC and scheduled for SNB at the only two university centres treating penile cancer in Denmark . All patients had a preoperative FDG PET/CT before SNB.…”

Section: Methodsmentioning

confidence: 99%

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

et al. 2015

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ObjectivesTo estimate the diagnostic accuracy of sentinel node biopsy (SNB) combined with preoperative 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for inguinal lymph node (LN) evaluation in patients with invasive penile squamous cell carcinoma (PSCC) with no clinical evidence of inguinal metastases (cN0) at two tertiary centres with complete clinical follow-up. Patients and MethodsFrom April 2010 in Centre one and from January 2013 in Centre two, we prospectively enrolled patients diagnosed with invasive PSCC and scheduled for SNB at the only two university centres treating penile cancer in Denmark. All patients had FDG PET/CT before SNB. The sentinel LNs were preoperatively located by planar lymphoscintigraphy in 134 groins (68 patients) and by single-photon emission CT/ CT in 120 groins (61 patients). The primary endpoints were the sensitivity, specificity, and false-negative rate of SNB combined with FDG PET/CT. The secondary endpoint was SNB-related morbidity. ResultsWe examined 254 groins in 129 patients by SNB combined with FDG PET/CT. The median (interquartile range, IQR) follow-up of survivors was 23 (14-35) months. Of 201 LNnegative groins, two were false negatives, and despite radiochemotherapy treatment, both patients died from penile cancer. Four of 23 radiotracer-silent groins, had a FDG PET/CT-positive LNs and were surgically explored. In one of four of the explored groins, a positive LN was found. Combined FDG PET/CT-SNB sensitivity was 94.4% (95% confidence interval [CI] 81-99%) per groin. The falsenegative rate was 5.6% (95% CI 1-19%) per groin. In 15 patients (11.6%) there were 25 SNB-related complications of Clavien-Dindo grades I-IIIa. The only Clavien-Dindo IIIa complication was an inguinal lymphocele treated by aspiration. ConclusionIn this study, we present a favourable SNB false-negative rate of 5.6% in a national cohort of clinically LN-negative patients with invasive PSCC with a pre-SNB FDG PET/CT scan. The combination of FDG PET/CT and SNB seems to be a promising diagnostic approach. Even so, a false-negative SNB was fatal in two of two cases and we are determined to continue the development of our SNB technique. The SNBrelated morbidity was limited.

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Section: Methodsmentioning

confidence: 99%

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

et al. 2015

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“…Despite ongoing advances and increasing level of specialization, there is still room for improvement of the appropriate infrastructure, care pathways and clinical competences to deliver effective interventions and support to patients with rare diseases in many European countries [34]. Of the Nordic countries, only Sweden, Denmark and Iceland have centralized penile cancer services, whereas a decentralized organization is maintained in Norway and Finland [35].…”

Section: Educationmentioning

confidence: 99%

A urologist’s contemporary guide to penile cancer

Jakobsen¹

2015

Scandinavian Journal of Urology

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Few urologists deal with penile cancer on a daily basis. Owing to the rarity of the disease and its diversity in presentation, clinical experience accumulates slowly and new paradigms spread sporadically. This review provides a concise update on the background, clinical features and multidisciplinary management strategies of penile cancer. The evidence base of penile cancer management recommendations is devoid of randomized controlled trials and relies mainly on retrospective cohort studies from single institutions. In recent years, international multicentre collaboration has increased the quality of evidence. Larger study cohorts allow researchers to engage in subgroup analysis of patients with poor prognosis, of which the literature so far has been scarce. Comprehensive evidence-based guidelines are available through the European Association of Urology. This review highlights the importance of early and minimally invasive regional lymph-node staging of all patients of stage T1G2 or higher, and underlines the therapeutic potential of inguinal lymph-node dissection in lymph-node positive patients. A discussion of the oncological safety of current trends towards more phallus-sparing treatment techniques emphasizes the importance of proper case selection, thorough patient information, consequent follow-up and the possibility of a reconstructive procedure after organ-sparing ablative penile surgery. The aetiological role of human papilloma virus (HPV) is touched upon and the evidence for circumcision and HPV vaccination of boys is briefly weighed. The value of multidisciplinary treatment of advanced penile cancer is underlined and the role of chemotherapy, radiotherapy and radiochemotherapy is discussed. Finally, the perspectives for hybrid tracer sentinel node, robot-assisted lymph-node surgery and targeted therapies are addressed.

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“…Penile cancer care in Denmark is centralized to two university centers 2. The DaPeCa-data monitors referral practice from regional hospitals and private practices within surgery/urology, dermatology, and general practice and monitors guideline adherence at the treating centers.…”

Section: Aim Of Databasementioning

confidence: 99%

“…The group behind the DaPeCa-data is active within the research field and publishes regularly on the topic;2,8–12 however, no research paper as of yet has used data registered in the DaPeCa-data due to the rarity of the disease and the fact that the database was only established in June 2011. The first validation study is under preparation.…”

Section: Examples Of Researchmentioning

confidence: 99%

The Danish National Penile Cancer Quality database

Jakobsen¹,

Öztürk

Søgaard

2016

CLEP

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Aim of databaseThe Danish National Penile Cancer Quality database (DaPeCa-data) aims to improve the quality of cancer care and monitor the diagnosis, staging, and treatment of all incident penile cancer cases in Denmark. The aim is to assure referral practice, guideline adherence, and treatment and development of the database in order to enhance research opportunities and increase knowledge and survival outcomes of penile cancer.Study populationThe DaPeCa-data registers all patients with newly diagnosed invasive squamous cell carcinoma of the penis in Denmark since June 2011.Main variablesData are systematically registered at the time of diagnosis by a combination of automated data-linkage to the central registries as well as online registration by treating clinicians. The main variables registered relate to disease prognosis and treatment morbidity and include the presence of risk factors (phimosis, lichen sclerosus, and human papillomavirus), date of diagnosis, date of treatment decision, date of beginning of treatment, type of treatment, treating hospital, type and time of complications, date of recurrence, date of death, and cause of death.Descriptive dataRegistration of these variables correlated to the unique Danish ten-digit civil registration number enables characterization of the cohort, individual patients, and patient groups with respect to age; 1-, 3-, and 5-year disease-specific and overall survival; recurrence patterns; and morbidity profile related to treatment modality. As of August 2015, more than 200 patients are registered with ∼65 new entries per year.ConclusionThe DaPeCa-data has potential to provide meaningful, timely, and clinically relevant quality data for quality maintenance, development, and research purposes.

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Penile cancer in Scandinavia: Current practice and future perspectives

Cited by 10 publications

References 8 publications

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

A urologist’s contemporary guide to penile cancer

The Danish National Penile Cancer Quality database

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Penile cancer in Scandinavia: Current practice and future perspectives

Cited by 10 publications

References 8 publications

DaPeCa‐3: promising results of sentinel node biopsy combined with 18F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

DaPeCa‐3: promising results of sentinel node biopsy combined with 18F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

A urologist’s contemporary guide to penile cancer

The Danish National Penile Cancer Quality database

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Product

Resources

About

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark

DaPeCa‐3: promising results of sentinel node biopsy combined with ¹⁸F‐fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node‐negative patients with penile cancer – a national study from Denmark