Predictive factors for local recurrence after glansectomy and neoglans reconstruction for penile squamous cell carcinoma
| Autor: | Maarten Albersen, Steven Joniau, Michelle Christodoulidou, Asif Muneer, Arie Parnham, Raj Nigam, David Ralph, Varun Sahdev, Alex Freeman, Fabio Castiglione, Charles Jameson, Peter Malone, Suks Minhas |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Oncology medicine.medical_specialty Urology 030232 urology & nephrology Perineural invasion Kaplan-Meier Estimate 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Penile cancer Glans Penile Neoplasms Pathological Aged Retrospective Studies Framingham Risk Score business.industry Carcinoma in situ Hazard ratio Retrospective cohort study Middle Aged Prognosis medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Carcinoma Squamous Cell Neoplasm Grading Neoplasm Recurrence Local business Organ Sparing Treatments Carcinoma in Situ Follow-Up Studies Penis |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations. 36:141-146 |
| ISSN: | 1078-1439 |
| DOI: | 10.1016/j.urolonc.2017.07.025 |
| Popis: | Objectives To investigate predictive pathological factors for local recurrence (LR) after glansectomy for penile squamous cell carcinoma (SCC) and to develop a risk score for prediction of LR after glansectomy. Patients and methods In this retrospective study, we analyzed 117 patients operated between February 2005 and January 2016 in a supraregional penile cancer center in the UK for LR after glansectomy and glans reconstruction. Univariate and multivariate Cox proportional hazards regression was used to identify 4 prognostic indicators for LR. The hazard ratio (HR) of LR was estimated in Kaplan-Meier analysis, and based on these data, we designed a postoperative model for prediction of LR based on 3 risk groups. Results Median follow-up period was 33.7 (95% CI: 26.8–40.3) months; 12.8% of the patients experienced LR. Univariate Cox proportional hazards regression revealed that the risk factors for recurrence were the presence of perineural invasion, carcinoma in situ, positive margin on definitive pathology, and high-grade disease. Based on Kaplan-Meier analysis stratified by number of factors present, we defined 3 risk groups for LR: low (0,1 risk factors) as reference, intermediate (2,3 risk factors) with HR of 13.9 (95% CI: 1.81–107.04, P = 0.0115), or high risk (all 4 risk factors present) with a HR of 34.2 (95% CI: 3.07–381.81, P = 0,0041). Limitations include the retrospective design and low number of events inherent to the rare nature of penile SCC. Conclusions Perineural invasion, carcinoma in situ, positive definitive margins, and the presence of high-grade SCC predict LR following glansectomy. These factors can be used to stratify patients into low-, intermediate-, and high-risk groups for recurrence which may be used to tailor follow-up. |
| Databáze: | OpenAIRE |
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