Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To assess local recurrence (LR) and its impact on cancer-specific survival (CSS) in an international multicentric homogeneous cohort of lower-risk patients with penile squamous cell carcinoma (PSCC) that underwent glans-sparing surgery (GSS). PATIENTS AND METHODS: We retrospectively studied patients with PSCC treated with circumcision, wide local excision, glans resurfacing, partial glansectomy and laser ablation, collectively defined as GSS. To understand whether LR itself impacts CSS, patients with lymphatic or systemic disease prior or concurrent with LR were excluded. Predictors of LR and its impact on CSS were assessed using Cox proportional hazard regression and Kaplan-Meier survival analysis, respectively. RESULTS: Across 15 institutions, 550 patients were included. The majority had pathological T1 stage (79%) tumours, reflecting the selection of less invasive tumours for GSS. At a median (interquartile range) follow-up of 41 (23-63) months, 162 (29%) patients experienced LR. LR did not affect cancer-specific mortality and 5-year CSS remained at 99%. Three patients died from penile cancer, none of whom showed a LR during their disease course. The presence of penile intraepithelial neoplasia in the surgical margin was an independent predictor of LR (hazard ratio 2.28, P = 0.02), even after adjusting for additional treatments. CONCLUSION: Patients undergoing GSS for PSCC demonstrate excellent survival outcomes, despite LR in 29% of men. These findings support the use of GSS as a safe and effective treatment option for patients committed to adequate follow-up.
Source: British Journal of Urology
DOI: 10.1111/bju.70055
Authors: Laura Elst, Eduard Roussel, Marija Miletic, Hielke‐Martijn De Vries, Rick Verdijk, Sylvia Yan, Hussain Alnajjar, Davide Perri, Aishwarya Kaur, Richard Barry Sirard, Sebastiano Nazzani, Giuseppe Basile, Marco Bandini, João Lobo, Nicola Di Nardo, Georgios Hatzichristodoulou, Andrea Salonia, Alberto Breda, Philippe E. Spiess, Nicola Nicolai, Christian Fankhauser, Arie Parnham, Marco Falcone, Giorgio Bozzini, Asif Muneer, Nick Watkin, Benjamin Ayres, Oscar R. Brouwer, Maarten Albersen
Institutions: Universitair Ziekenhuis Leuven, KU Leuven, The Netherlands Cancer Institute, St George’s University Hospitals NHS Foundation Trust, University College Hospital, UCL Biomedical Research Centre, University College London, Ospedale Sant'Anna, The Christie Hospital, The Christie NHS Foundation Trust, University of South Florida, Fondazione IRCCS Istituto Nazionale dei Tumori, Puigvert Foundation, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, Universidade do Porto, IPO Porto, Centro de Investigação do Instituto Português de Oncologia do Porto Francisco Gentil, RISE - Health Research Network, Instituto de Ciências Biomédicas Albel Salazar, University of Lucerne, Martha-Maria Hospital, Moffitt Cancer Center, University of Zurich, Biruni University, University of Turin
Language: English
Topic: Genital Health and Disease
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4415785666