Management of Lymph Node-positive Penile Cancer: A Systematic Review

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • Tiago Vieira Da Conceicao Antunes Lopes

    Autor

Participantes de fora da FMUP

  • Sachdeva, Ashwin
  • McGuinness, Luke
  • Zapala, Lukasz
  • Greco, Isabella
  • Garcia-Perdomof, Herney Andres
  • Kailavasan, Mithun
  • Ayresi, Benjamin
  • Barretoj, Lenka
  • Campi, Riccardo
  • Crook, Juanita
  • Johnstone, Peter
  • Kumar, Vivek
  • Manzie, Kenneth
  • Marcusp, Jack David
  • Necchi, Andrea
  • Oliveira, Pedro
  • Osborne, John
  • Pagliaro, Lance C.
  • Protzel, Chris
  • Rumble, R. Bryan
  • Martinez, Diego F. Sanchez
  • Spiess, Philippe E.
  • Tagawa, Scott T.
  • van der Heijden, Michiel S.
  • Parnham, Arie S.
  • Pettaway, Curtis A.
  • Albersen, Maarten
  • Sangar, Vijay K.
  • Brouwer, Oscar R.
  • Sakalis, Vasileios I.

Unidades de investigação

Abstract

Context: Lymph node (LN) involvement in penile cancer is associated with poor survival. Early diagnosis and management significantly impact survival, with multimodal treatment approaches often considered in advanced disease. Objective: To assess the clinical effectiveness of treatment options available for the management of inguinal and pelvic lymphadenopathy in men with penile cancer. Evidence acquisition: EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews, and other databases were searched from 1990 to July 2022. Randomised controlled trials (RCTs), nonrandomised comparative studies (NRCSs), and case series (CSs) were included. Evidence synthesis: We identified 107 studies, involving 9582 patients from two RCTs, 28 NRCSs, and 77 CSs. The quality of evidence is considered poor. Surgery is the mainstay of LN disease management, with early inguinal LN dissection (ILND) associated with better outcomes. Videoendoscopic ILND may offer comparable survival outcomes to open ILND with lower wound -related morbidity. Ipsilateral pelvic LN dissection (PLND) in N2-3 cases improves overall survival in comparison to no pelvic surgery. Neoadjuvant chemotherapy in N2-3 disease showed a pathological complete response rate of 13% and an objective response rate of 51%. Adjuvant radiotherapy may benefit pN2-3 but not pN1 disease. Adjuvant chemoradiotherapy may provide a small survival benefit in N3 disease. Adjuvant radiotherapy and chemotherapy improve outcomes after PLND for pelvic LN metastases. Conclusions: Early LND improves survival in nodal disease in penile cancer. Multimodal treatments may provide additional benefit in pN2-3 cases; however, data are limited. Therefore, individualised management of patients with nodal disease should be discussed in a multidisciplinary team setting. Patient summary: Spread of penile cancer to the lymph nodes is best managed with surgery, which improves survival and has curative potential. Supplementary treatment, including the use of chemotherapy and/or radiotherapy, may further improve survival in advanced disease. Patients with penile cancer with lymph node involvement should be treated by a multidisciplinary team. (c) 2023 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/).

Dados da publicação

ISSN/ISSNe:
1873-7560, 1421-993X

European Urology  Elsevier

Tipo:
Review
Páginas:
257-273
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 14

Citações Recebidas na Scopus: 15

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Keywords

  • Penile cancer; Lymph-node management; Management; Inguinal lymph-node dissection; Chemotherapy; Radiotherapy; Chemoradiotherapy; Multimodal therapy

Proyectos asociados

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Investigador Principal: Tiago Vieira da Conceicao Antunes Lopes

Estudo Clínico Académico (Carcinoma Renal) . 2023

Fatores De Prognóstico No Cancro Do Pénis - Devemos Evitar O Estadiamento Dos Gânglios Linfáticos Inguinais ?

Investigador Principal: Tiago Vieira da Conceicao Antunes Lopes

Estudo Clínico Académico . 2020

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