Department of Medical Oncology, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France.
Department of Urology, Bordeaux University Hospital, Bordeaux, France.
Cancer Treat Rev. 2020 Nov;90:102087. doi: 10.1016/j.ctrv.2020.102087. Epub 2020 Aug 7.
Penile cancer (PeCa) is a rare disease worldwide, accounting for less than one percent of all malignancies in men. It usually presents as a painless ulcer or lump on the head of the penis. Squamous cell carcinoma represents the most common histological subtype of PeCa, with pathogenesis intimately linked to chronic Human Papilloma Virus (HPV) infection. Surgery is the cornerstone for the treatment of primary PeCa with potential mutilating outcome depending on the nodal extension of the disease. However, in case of extensive lymph node involvement, multidisciplinary treatment including perioperative chemotherapy and inclusion in clinical trial should be considered. To date, advanced or metastatic disease still have poor prognosis and are a therapeutic challenge with limited options, highlighting the need of new treatments and further investigations. Growing efforts to identify molecular alterations, understand the role of HPV and characterize immune contexture have expanded over the past years, providing further perspectives in prognostication, predictive biomarkers and therapeutic intervention. In this review, we provide an updated overview of current management of PeCa focusing on perioperative strategy. We discuss about new insights of the biology of PeCa and comment future directions in the field.
阴茎癌（PeCa）是一种罕见的疾病，在全球范围内占男性所有恶性肿瘤的不到 1%。它通常表现为阴茎头部无痛性溃疡或肿块。鳞状细胞癌是 PeCa 最常见的组织学亚型，其发病机制与慢性人乳头瘤病毒（HPV）感染密切相关。手术是治疗原发性 PeCa 的基石，但根据疾病的淋巴结扩展情况，可能会导致致残性结果。然而，在广泛淋巴结受累的情况下，应考虑多学科治疗，包括围手术期化疗和临床试验纳入。迄今为止，晚期或转移性疾病的预后仍然较差，治疗选择有限，这突显了对新的治疗方法和进一步研究的需求。近年来，人们越来越努力地识别分子改变、了解 HPV 的作用和描绘免疫结构，这为预后、预测生物标志物和治疗干预提供了更多的视角。在这篇综述中，我们提供了当前 PeCa 治疗的最新概述，重点是围手术期策略。我们讨论了 PeCa 生物学的新见解，并对该领域的未来方向进行了评论。
