Musi Gennaro, Molinari Filippo, Mistretta Francesco A, Piccinelli Mattia Luca, Guzzo Sonia, Tozzi Marco, Lievore Elena, Blezien Oskar, Fontana Matteo, Cioffi Antonio, Cullurà Daniela, Verri Elena, Cossu Rocca Maria, Nolè Franco, Ferro Matteo, de Cobelli Ottavio, Luzzago Stefano
Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milan, Italy.
Department of Oncology and Hematology-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.
Cancers (Basel). 2023 Sep 29;15(19):4807. doi: 10.3390/cancers15194807.
We tested the feasibility and oncological outcomes after penile-sparing surgery (PSS) for local recurrent penile cancer after a previous glansectomy/partial penectomy. We retrospectively analysed 13 patients (1997-2022) with local recurrence of penile cancer after a previous glansectomy or partial penectomy. All patients underwent PSS: circumcision, excision, or laser ablation. First, technical feasibility, treatment setting, and complications (Clavien-Dindo) were recorded. Second, Kaplan-Meier plots depicted overall and local recurrences over time. Overall, 11 (84.5%) vs. 2 (15.5%) patients were previously treated with glansectomy vs. partial penectomy. The median (IQR) time to disease recurrence was 56 (13-88) months. Six (46%) vs. two (15.5%) vs. five (38.5%) patients were treated with, respectively, local excision vs. local excision + circumcision vs. laser ablation. All procedures, except one, were performed in an outpatient setting. Only one Clavien-Dindo 2 complication was recorded. The median follow-up time was 41 months. Overall, three (23%) vs. four (30.5%) patients experienced local vs. overall recurrence, respectively. All local recurrences were safely treated with salvage surgery. In conclusion, we reported the results of a preliminary analysis testing safety, feasibility, and early oncological outcomes of PSS procedures for patients with local recurrence after previous glansectomy or partial penectomy. Stronger oncological outcomes should be tested in other series to optimise patient selection.
我们对先前进行过龟头切除术/部分阴茎切除术后局部复发性阴茎癌患者行保留阴茎手术(PSS)的可行性及肿瘤学结局进行了测试。我们回顾性分析了13例(1997 - 2022年)先前进行过龟头切除术或部分阴茎切除术后出现阴茎癌局部复发的患者。所有患者均接受了PSS:包皮环切术、切除术或激光消融术。首先,记录技术可行性、治疗环境及并发症(Clavien - Dindo分级)。其次,绘制Kaplan - Meier曲线以描述总体和局部复发随时间的情况。总体而言,先前接受龟头切除术的患者为11例(84.5%),接受部分阴茎切除术的患者为2例(15.5%)。疾病复发的中位(IQR)时间为56(13 - 88)个月。分别有6例(46%)、2例(15.5%)和5例(38.5%)患者接受了局部切除术、局部切除术 + 包皮环切术和激光消融术治疗。除1例手术外,所有手术均在门诊进行。仅记录到1例Clavien - Dindo 2级并发症。中位随访时间为41个月。总体而言,分别有3例(23%)和4例(30.5%)患者出现局部复发和总体复发。所有局部复发均通过挽救性手术得到安全治疗。总之,我们报告了一项初步分析的结果,该分析测试了先前进行过龟头切除术或部分阴茎切除术后局部复发患者行PSS手术的安全性、可行性及早期肿瘤学结局。应在其他系列研究中测试更强有力的肿瘤学结局,以优化患者选择。