Other take-home messages in penile/urethral cancer included discussion of proposed 2018 AJCC penile cancer guidelines as well as the finding that in women with primary urethral cancer, adenocarcinoma was the most common pathology.
Anne Kathryn Schuckman, MDOther take-home messages in penile/urethral cancer included discussion of proposed 2018 AJCC penile cancer guidelines as well as the finding that in women with primary urethral cancer, adenocarcinoma was the most common pathology. The take-homes were presented by Anne Kathryn Schuckman, MD, of the University of Southern California, Los Angeles.
In the U.S., guidelines on surgical inguinal lymph node staging for penile cancer were followed in only 25% of patients with T1b-T3 disease. This was significantly associated with treatment at a non-academic hospital, and those who did not undergo surgical inguinal node staging had worse overall survival. In Europe, adherence to treatment guidelines for primary therapy was 66% and for lymphadenectomy, the adherence rate was as high as 70%.
Under new American Joint Committee on Cancer (AJCC) staging, all urothelial carcinoma in situ has been collapsed into Tis as opposed to being confused with T4 disease. Clarification has been made between T1 and T4 disease and a distinction made between N1 (one lymph node positive) and N2 (greater than one node positive).
In proposed 2018 AJCC penile cancer guidelines, cavernosal involvement will upstage a patient to T3 disease.
An abstract examining the ability of this new penile cancer staging system to better predict lymph node involvement at the time of lymph node dissection found no difference in lymph node status among T3 versus T2 patients.
Penile-sparing surgical approaches for penile carcinoma including circumcision, wide local excision, laser therapy, glansectomy, and glans resurfacing generally provide adequate oncologic control. However, those treated with laser and wide local excision were at greater risk for recurrence.
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