To evaluate recurrence outcomes of penile sparing surgery (PSS) in the largest multicenter cohort of patients to date.
We retrospectively identified patients treated with PSS from May 1990 to July 2016 at five tertiary referral institutions.
Treatments consisted of circumcision, wide local excision, laser therapy with or without local excision, partial or total glansectomy, and glans resurfacing. Primary endpoint was local recurrence free survival (LRFS) and defined from initial treatment to time of local recurrence and estimated with the Kaplan-Meier method.
After exclusion criteria, a total of 1,188 patients were included in the analysis. Over a median follow-up of 43.0 months, there were 252 (21.2%) local recurrences with 39.3% (99/252) occurring in the first year. Median time to local recurrence was 16.3 months and the 5-year LRFS was 73.6%. When stratified by stage, 5-yr LRFS were 75.0%, 71.4%, and 75.9% for Ta/Tis, T1, and T2 cases, respectively (log-rank p=0.748). The majority (58.3%) of recurrences were treated with repeat organ sparing procedures and the secondary partial (total) penectomy rate was 19.0%. Only margin status was significantly associated with a local recurrence on multivariate analysis (p=0.001). Limitations include retrospective design and heterogeneous clinical approach.
PSS can provide excellent local control for superficial penile tumors as well as for appropriately selected invasive lesions. A strict follow-up in the early post-operative period is highly recommended.
The Journal of urology. 2017 Nov 10 [Epub ahead of print]
Adam Baumgarten, Juan Chipollini, Sylvia Yan, Sarah R Ottenhof, Dominic H Tang, Désirée Draeger, Chris Protzel, Yao Zhu, Ding-Wei Ye, Oliver W Hakenberg, Simon Horenblas, Nicholas A Watkin, Philippe E Spiess
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA., Department of Urology, St George's Healthcare NHS Trust, Tooting, London, UK., Department of Urological Oncology, Netherlands Cancer Institute, Amsterdam, Netherlands., Department of Urology, University Hospital Rostock, Rostock, Germany., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China., Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA. Electronic address: .