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Is really necessary change TNM classification for penile cancer?
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1760
Scavuzzo A.1, Reynoso Noveron N2, Martinez-Cervera P.1, Santana Rios Z.1, Jimenez-Rios M.A.1 1
Instituto Nacional De Cancerologia, Dept. of Urology, Mexico City, Mexico, 2Instituto Nacional De Cancerologia, Dept. of Epidemiology, Mexico City, Mexico INTRODUCTION & OBJECTIVES: Currently there is debate about proposal modification category T2 in T2a with spongiosum-only invasion and T2b with tunica and/or corpus cavernosum invasion for penile cancer. Leijte et all suggest that survival of T3 was higher than T2b (67.7% vs 52.6%) and there is difference in survival between T2a and T2b. The aim of the present study was to describe clinical and pathological characteristics and Cancer Specific Survival (CSS). MATERIAL & METHODS: The records of 378 pts with penile cancer, treated at National Cancer Institute (INCan) of Mexico City, between January 1989-December 2015, were analysed. Survival in the different categories was compared using Kaplan-Meier analysis and the log rank test. Statistical analysis was performed with SSPS 22 (SPSS Inc., Chicago, IL, USA) and R statistical package v.3.2. RESULTS: The average time of follow-up was 30 months (IQR 2-156). The table 1 shows patient characteristics at presentation. At initial presentation, 163 (43.1%) had clinically palpable nodes (cN+) bilaterally, 71 (18%) cN+unilateraly and 111 (29%) without clinically palpable nodes. pT1a presented as ulcerative lesions (42.9%), verrucous subtype (35.7%),pT2- pT3 had 30% and 34.6% of verrucous carcinoma. Between stage pT2, 66.67% (n. 76/120) present infiltration to corpus spongiosum and 71,05% to corpus cavernosum (n. 81/120). 84.7% had SCC and 4, 5% other histological types. Median lesion size was 2.8 cm (range 0,5 -15). 14% pts were not candidates for surgery due to large tumors and cN3. Lymphadenectomy performed in 137 patients (36.2%). 121 patients were alive and diseasefree; while 79 (20.9%) died of penile cancer. The 5-year CSS for all patients was >75.04%. Figure 1- 2 shows Kaplan-Meier curves of T category; significant difference in survival was found between pT2 and pT3 (p 0.047). A 5 yrs CSS classified by T categories was: pT1 96,67%, pT2: 88,27%, pT3: 58,47%, pT4 0%. A 5 yrs CSS for T2 with infiltration to corpus spongiosum was: 80,86%; for T2 with infiltration to corpus cavernosum was 87,84% (p 0.953). CSS among the pN categories: pN1= 100%, pN2= 50%, pN3= 33%, pN0: 99%.
Eur Urol Suppl 2016; 15(13);e1760
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1761
Eur Urol Suppl 2016; 15(13);e1761
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1762
Eur Urol Suppl 2016; 15(13);e1762
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1763
Table 1 Mean age pT stage Tis T1a T1b T2 T3 T4 Tx Nstage pN0 pN1 pN2 pN3 pNx cN 1-3 cM M0 M1 Mx Grade G1 G2 G3-4 Gx Surgical treatment Partial penectomy Total penectomy Circuncision Resection of lesion Biopsy/ Topical 5-fluorouracil cream 5% No surgery Refused surgical treatment
N=378 Pts ( %) 56.8 ± 15.05 (range 23-98) 5 (1.3%) 42 (11.1%) 36 (9.5%) 120 ( 31.7) 81 (21.4%) 18 (4.8%) 76 (20.1%) 90 ( 23%) 33 ( 8,7%) 19 ( 5.2%) 18 ( 4,7%) 136 ( 35,9%) 82 ( 21%) 272( 72%) 52 ( 13. 8%) 54 ( 14. 3%) 93 ( 24.6%) 204 ( 54 %) 33 (8.2%) 48 (12.7%) 123 ( 32.5%) 125 ( 32.5) 16 ( 4.2%) 21 (5.6%) 17 ( 4.5%) 53 ( 14 %) 20 ( 5.3%)
CONCLUSIONS: We found a significant difference in survival between T3 and T2 and don’t difference in subcategory of pT2. The current TNM classification is adequate to differentiate in terms of survival.
Eur Urol Suppl 2016; 15(13);e1763 Powered by TCPDF (www.tcpdf.org)
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1760
Scavuzzo A.1, Reynoso Noveron N2, Martinez-Cervera P.1, Santana Rios Z.1, Jimenez-Rios M.A.1 1
Instituto Nacional De Cancerologia, Dept. of Urology, Mexico City, Mexico, 2Instituto Nacional De Cancerologia, Dept. of Epidemiology, Mexico City, Mexico INTRODUCTION & OBJECTIVES: Currently there is debate about proposal modification category T2 in T2a with spongiosum-only invasion and T2b with tunica and/or corpus cavernosum invasion for penile cancer. Leijte et all suggest that survival of T3 was higher than T2b (67.7% vs 52.6%) and there is difference in survival between T2a and T2b. The aim of the present study was to describe clinical and pathological characteristics and Cancer Specific Survival (CSS). MATERIAL & METHODS: The records of 378 pts with penile cancer, treated at National Cancer Institute (INCan) of Mexico City, between January 1989-December 2015, were analysed. Survival in the different categories was compared using Kaplan-Meier analysis and the log rank test. Statistical analysis was performed with SSPS 22 (SPSS Inc., Chicago, IL, USA) and R statistical package v.3.2. RESULTS: The average time of follow-up was 30 months (IQR 2-156). The table 1 shows patient characteristics at presentation. At initial presentation, 163 (43.1%) had clinically palpable nodes (cN+) bilaterally, 71 (18%) cN+unilateraly and 111 (29%) without clinically palpable nodes. pT1a presented as ulcerative lesions (42.9%), verrucous subtype (35.7%),pT2- pT3 had 30% and 34.6% of verrucous carcinoma. Between stage pT2, 66.67% (n. 76/120) present infiltration to corpus spongiosum and 71,05% to corpus cavernosum (n. 81/120). 84.7% had SCC and 4, 5% other histological types. Median lesion size was 2.8 cm (range 0,5 -15). 14% pts were not candidates for surgery due to large tumors and cN3. Lymphadenectomy performed in 137 patients (36.2%). 121 patients were alive and diseasefree; while 79 (20.9%) died of penile cancer. The 5-year CSS for all patients was >75.04%. Figure 1- 2 shows Kaplan-Meier curves of T category; significant difference in survival was found between pT2 and pT3 (p 0.047). A 5 yrs CSS classified by T categories was: pT1 96,67%, pT2: 88,27%, pT3: 58,47%, pT4 0%. A 5 yrs CSS for T2 with infiltration to corpus spongiosum was: 80,86%; for T2 with infiltration to corpus cavernosum was 87,84% (p 0.953). CSS among the pN categories: pN1= 100%, pN2= 50%, pN3= 33%, pN0: 99%.
Eur Urol Suppl 2016; 15(13);e1760
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1761
Eur Urol Suppl 2016; 15(13);e1761
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1762
Eur Urol Suppl 2016; 15(13);e1762
8th European Multidisciplinary Meeting on Urological Cancers, 24-27 November 2016, Milan, Italy
P159
Is really necessary change TNM classification for penile cancer? Eur Urol Suppl 2016; 15(13);e1763
Table 1 Mean age pT stage Tis T1a T1b T2 T3 T4 Tx Nstage pN0 pN1 pN2 pN3 pNx cN 1-3 cM M0 M1 Mx Grade G1 G2 G3-4 Gx Surgical treatment Partial penectomy Total penectomy Circuncision Resection of lesion Biopsy/ Topical 5-fluorouracil cream 5% No surgery Refused surgical treatment
N=378 Pts ( %) 56.8 ± 15.05 (range 23-98) 5 (1.3%) 42 (11.1%) 36 (9.5%) 120 ( 31.7) 81 (21.4%) 18 (4.8%) 76 (20.1%) 90 ( 23%) 33 ( 8,7%) 19 ( 5.2%) 18 ( 4,7%) 136 ( 35,9%) 82 ( 21%) 272( 72%) 52 ( 13. 8%) 54 ( 14. 3%) 93 ( 24.6%) 204 ( 54 %) 33 (8.2%) 48 (12.7%) 123 ( 32.5%) 125 ( 32.5) 16 ( 4.2%) 21 (5.6%) 17 ( 4.5%) 53 ( 14 %) 20 ( 5.3%)
CONCLUSIONS: We found a significant difference in survival between T3 and T2 and don’t difference in subcategory of pT2. The current TNM classification is adequate to differentiate in terms of survival.
Eur Urol Suppl 2016; 15(13);e1763 Powered by TCPDF (www.tcpdf.org)