Penile tissue preserving methods in the treatment of lower T categories of penile cancer
Authors:
Milan Hora 1; Ivan Trávníček 1; Kristýna Kalusová 1; Ondřej Hes 2; Karel Pizinger 3; Tomáš Fikrle 3; Jan Říčař 3; Dmitry Kazakov 2; Denisa Kacerovská 2; Michal Michal 2
Authors place of work:
Urologická klinika LF UK a FN, Plzeň
1; Šiklův patologicko-anatomický ústav LF UK a FN, Plzeň
2; Dermatovenerologická klinika LF UK a FN, Plzeň
3
Published in the journal:
Ces Urol 2014; 18(3): 199-207
Category:
Review article
Summary
Aim:
Standard treatment of lower T categories of penile cancer usually includes partial amputation. However, in a significant number of cases, this approach could prove to be an overtreatment. Today, we have a possibility to use other less, radical methods, which proved to be sufficient. This article provides a review of these treatment alternatives.
Overview:
An ideal method to treat a localized lesion would be its excision. Unfortunately, in penile cancer, this option is only rarely acceptable. A flat lesion type of PeIN (penile intraepitelial neoplasia) or carcinoma in situ can be treated by local therapy (5-fluorouracil, imiquimod, photodynamic therapy – senzibilisator aminolevulinate). The alternative options are destruction with CO2, Nd:YAG or Er:YAG laser. These methods can be replaced by technically challenging surgery, namely resurfacing with skin graft. Mohs method frequently mentioned in the literature for treatment of cancerous lesions of skin (consecutive excisions with repeated peroperative pathological investigation of margins) is not widely used in penile cancer. In more locally advanced tumours, with failure of the above mentioned less radical methods, in cases where the patients prefers faster and/or more radical treatment, or in cases when appropriate follow-up could not be guaranteed, a glansectomy is indicated. Brachytherapy represents an alternative with worse results, and should be reserved only for men who refuse surgery.
Conclusion:
Contemporary penis preserving methods allow us, even in case of precancerous PeIN, complete preservation of the organ. There are no clear recommendations guiding the selection of the specific treatment modalities and/or sequence of individual treatments. The choice of treatment depends on the preferences of the physician and the patient. As in other areas of oncourology, the involvement of a multidisciplinary team is crucial (most importantly it has to include pathologist, dermatovenereologist and urologist). Referral of patients to highly specialised centres is highly recommended.
Key words:
penile cancer, penile intraepithelial neoplasia, 5-fluorouracil, imiquimod, photodynamic therapy, resurfacing, laser, glansectomy.
Zdroje
1. Novák J, Žídek I. Carcinoma of penis. Praha: Praha Publishing 1996.
2. Babjuk M. Problematika uzlinového postižení u karcinomu penisu. Urol List 2005; 3(4): 10–13.
3. Čermák A, Pacík D. Terapie nádorů penisu. In: Dvořáček J, Babjuk M (eds.) Onkourologie. Praha: Galén 2005; 453–469.
4. Hora M, Pizinger K, Bursa V, Sviták M, Stránský P, Eret V, et al. Glansektomie v léčbě karcinomu penisu (Role of glansectomy in treatment of penile cancer). Ces Urol 2011; 15(1): 15–23.
5. Hora M, Trávníček I, Stránský P, Hes O, Kacerovská D, Kazakov D, et al. Excize sentinelové uzliny u karcinomu penisu. Ces Urol 2011; 16(Suppl 1): 88.
6. Trávníček I, Hora M, Ferda J, Ferdová E, Hes O, Stránský P, et al. Využití 18FDG PET-CT k detekci metastického postižení lymfatických uzlin u karcinomu penisu. Ces Urol 2013; 17(1 Suppl): 31.
7. Vik V, Nencka P, Záleský M, Zachoval R. Lichen sclerosus – stále přehlížená urologická diagnóza se závažnými komplikacemi. Ces Urol 2011; 15(2): 78–84.
8. Pávek V, Drábek M, Lavička Z. Lymfadenektomie sentinelové uzliny epidermoidního karcinomu penisu. Ces Urol 2012; 16(2): 125–128.
9. Michal M, Hes O, Kacerovská D, Hora M, Rotter L, Kazakov D. Klasifikace intraepiteliálních neoplázií předcházejících dlaždicovému karcinomu penisu a jejich analogie s prekancerózy dlaždicových karcinomů vulvy – přehled. Ces Urol 2014; 18(2): 94–100.
10. Velazquez EF, Chaux A, Cubilla AL. Histologic classification of penile intraepithelial neoplasia. Seminars in diagnostic pathology 2012; 29(2): 96–102.
11. Paoli J, Ternesten Bratel A, Lowhagen GB, Stenquist B, Forslund O, Wennberg AM. Penile intraepithelial neoplasia: results of photodynamic therapy. Acta dermato-venereologica. 2006; 86(5): 418–421.
12. Pizzocaro G, Algaba F, Horenblas S, Solsona E, Tana S, Van Der Poel H, et al. EAU penile cancer guidelines 2009. European urology 2010; 57(6): 1002–1012.
13. Alnajjar HM, Lam W, Bolgeri M, Rees RW, Perry MJ, Watkin NA. Treatment of carcinoma in situ of the glans penis with topical chemotherapy agents. European urology 2012; 62(5): 923–928.
14. Hadway P, Corbishley CM, Watkin NA. Total glans resurfacing for premalignant lesions of the penis: initial outcome data. BJU Int. 2006; 98(3): 532–536.
15. Zukiwskyj M, Daly P, Chung E. Penile cancer and phallus preservation strategies: a review of current literature. BJU Int. 2013; 112(Suppl 2): 21–26.
16. Brady KL, Mercurio MG, Brown MD. Malignant tumors of the penis. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al] 2013; 39(4): 527–547.
17. Stables GI, Stringer MR, Robinson DJ, Ash DV. Erythroplasia of Queyrat treated by topical aminolaevulinic acid photodynamic therapy. The British journal of dermatology 1999; 140(3): 514–517.
18. Bozzini G, Colin P, Betrouni N, Nevoux P, Ouzzane A, Puech P, et al. Photodynamic therapy in urology: what can we do now and where are we heading? Photodiagnosis and photodynamic therapy 2012; 9(3): 261–273.
19. Cinotti E, Perrot JL, Labeille B, Douchet C, Mottet N, Cambazard F. Laser photodynamic treatment for in situ squamous cell carcinoma of the glans monitored by reflectance confocal microscopy. The Australasian journal of dermatology 2014; 55(1): 72–74.
20. Ayer J, Matthews S, Francis N, Walker NP, Dinneen M, Bunker CB. Successful treatment of Buschke-Lowenstein tumour of the penis with carbon dioxide laser vaporization. Acta dermato-venereologica 2012; 92(6): 656–657.
21. Bandieramonte G, Colecchia M, Mariani L, Lo Vullo S, Pizzocaro G, Piva L, et al. Peniscopically controlled CO2 laser excision for conservative treatment of in situ and T1 penile carcinoma: report on 224 patients. European urology 2008; 54(4): 875–882.
22. Schlenker B, Tilki D, Seitz M, Bader MJ, Reich O, Schneede P, et al. Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up. BJU Int. 2010; 106(6): 786–790.
23. Alexiades-Armenakas MR, Dover JS, Arndt KA. Fractional laser skin resurfacing. Journal of drugs in dermatology: JDD 2012; 11(11): 1274–1287.
24. Shindel AW, Mann MW, Lev RY, Sengelmann R, Petersen J, Hruza GJ, et al. Mohs micrographic surgery for penile cancer: management and long-term followup. The Journal of urology 2007; 178(5): 1980–1985.
25. Depasquale I, Park AJ, Bracka A. The treatment of balanitis xerotica obliterans. BJU Int. 2000; 86(4): 459–465.
26. Palminteri E, Berdondini E, Lazzeri M, Mirri F, Barbagli G. Resurfacing and reconstruction of the glans penis. European urology 2007; 52(3): 893–898.
27. Romero FR, Romero KR, Mattos MA, Garcia CR, Fernandes Rde C, Perez MD. Sexual function after partial penectomy for penile cancer. Urology 2005; 66(6): 1292–1295.
28. Delaunay B, Soh PN, Delannes M, Riou O, Malavaud B, Moreno F, et al. Brachytherapy for penile cancer: Efficacy and impact on sexual function. Brachytherapy. 2013 [Epub ahead of print].
29. Carrozzo AM, Sedda AF, Muscardin L, Donati P, Cipriani C. Dermo beta brachytherapy with 188-Re in squamous cell carcinoma of the penis: a new therapy. European journal of dermatology 2013; 23(2): 183–188.
30. Crook JM, Haie-Meder C, Demanes DJ, Mazeron JJ, Martinez AA, Rivard MJ. American Brachytherapy Society-Groupe Europeen de Curietherapie-European Society of Therapeutic Radiation Oncology (ABS-GEC-ESTRO) consensus statement for penile brachytherapy. Brachytherapy 2013; 12(3): 191–198.
Štítky
Paediatric urologist Nephrology UrologyČlánok vyšiel v časopise
Czech Urology
2014 Číslo 3
Najčítanejšie v tomto čísle
- Varicocele
- Age specific PSA and PSA velocity – comparison on the basis of prostate biopsies
- Active surveillance in prostate cancer
- Penile tissue preserving methods in the treatment of lower T categories of penile cancer