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  • Zhu, Yao  (8)
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  • 1
    In: BJU International, August 2015, Vol.116(2), pp.196-201
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/bju.13009/abstract Byline: Jared M. Gopman, Rosa S. Djajadiningrat, Adam S. Baumgarten, Patrick N. Espiritu, Simon Horenblas, Yao Zhu, Chris Protzel, Julio M. Pow-Sang, Timothy Kim, Wade J. Sexton, Michael A. Poch, Philippe E. Spiess Keywords: complications; inguinal lymph node dissection; penile cancer Objectives To assess the potential complications associated with inguinal lymph node dissection (ILND) across international tertiary care referral centres, and to determine the prognostic factors that best predict the development of these complications. Materials and Methods A retrospective chart review was conducted across four international cancer centres. The study population of 327 patients underwent diagnostic/therapeutic ILND. The endpoint was the overall incidence of complications and their respective severity (major/minor). The Clavien-Dindo classification system was used to standardize the reporting of complications. Results A total of 181 patients (55.4%) had a postoperative complication, with minor complications in 119 cases (65.7%) and major in 62 (34.3%). The total number of lymph nodes removed was an independent predictor of experiencing any complication, while the median number of lymph nodes removed was an independent predictor of major complications. The American Joint Committee on Cancer stage was an independent predictor of all wound infections, while the patient's age, ILND with Sartorius flap transposition, and surgery performed before the year 2008 were independent predictors of major wound infections. Conclusions This is the largest report of complication rates after ILND for squamous cell carcinoma of the penis and it shows that the majority of complications associated with ILND are minor and resolve without prolonged morbidity. Variables pertaining to the extent of disease burden have been found to be prognostic of increased postoperative morbidity.
    Keywords: Complications ; Inguinal Lymph Node Dissection ; Penile Cancer
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 2
    Language: English
    In: The Journal of Urology, April 2017, Vol.197(4), pp.e1084-e1085
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2017.02.2516 Byline: Adam Baumgarten Author Affiliation: Tampa, FL Article Note: (footnote) Source of Funding: None
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 3
    Language: English
    In: The Journal of Urology, April 2017, Vol.197(4), pp.e975-e975
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2017.02.2228 Byline: Juan Chipollini, Adam Baumgarten, Dominic Tang Author Affiliation: Tampa, FL Article Note: (footnote) Source of Funding: none
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 4
    Language: English
    In: The Journal of Urology, May 2018, Vol.199(5), pp.1233-1237
    Description: We evaluated recurrence outcomes of penile sparing surgery in what is to our knowledge the largest multicenter cohort of patients to date. We retrospectively identified patients treated with penile sparing surgery from May 1990 to July 2016 at 5 tertiary referral institutions. Treatments consisted of circumcision, wide local excision, laser therapy with or without local excision, partial or total glansectomy and glans resurfacing. The study primary end point was local recurrence-free survival, defined from initial treatment to time of local recurrence and estimated with the Kaplan-Meier method. After applying study exclusion criteria 1,188 patients were included in analysis. During the median followup of 43.0 months there were 252 local recurrences (21.2%), of which 99 (39.3%) developed in year 1. Median time to local recurrence was 16.3 months and the 5-year local recurrence-free survival incidence was 73.6%. When stratified by stage, the 5-year local recurrence-free survival rate was 75.0%, 71.4% and 75.9% in Ta/Tis, T1 and T2 cases, respectively (log rank p = 0.748). Of the recurrences 58.3% were treated with repeat organ sparing procedures and the secondary partial (total) penectomy rate was 19.0%. Only margin status was significantly associated with local recurrence on multivariate analysis (p = 0.001). Study limitations included the retrospective design and the heterogeneous clinical approach. Penile sparing surgery can provide excellent local control for superficial penile tumors as well as for appropriately selected invasive lesions. Strict followup in the early postoperative period is highly recommended.
    Keywords: Penile Neoplasms ; Neoplasm Recurrence ; Local ; Organ Sparing Treatments ; Carcinoma ; Squamous Cell ; Mortality ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 5
    Language: English
    In: The Journal of Urology, April 2014, Vol.191(4), pp.e92-e92
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 6
    In: BJU International, March 2018, Vol.121(3), pp.393-398
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/bju.14037/abstract Byline: Juan Chipollini, Sylvia Yan, Sarah R. Ottenhof, Yao Zhu, Desiree Draeger, Adam S. Baumgarten, Dominic H. Tang, Chris Protzel, Ding-wei Ye, Oliver W. Hakenberg, Simon Horenblas, Nicholas A. Watkin, Philippe E. Spiess Keywords: carcinoma in situ; recurrence; #PenileCancer Objectives To evaluate recurrence after penile-sparing surgery (PSS) in the management of carcinoma in situ (CIS) of the penis in a large multicentre cohort of patients. Patients and Methods We identified consecutive patients from five major academic centres, treated between June 1986 and November 2014, who underwent PSS for pathologically proven penile CIS. The primary outcome was local recurrence-free survival (RFS), which was estimated using the Kaplan-Meier method. Results A total of 205 patients were identified. Treatment methods included circumcision, glansectomy, wide local excision, laser therapy and total glans resurfacing. Over a median (interquartile range [IQR]) follow-up of 40 (26-65.6) months, there were 48 local recurrences, with 45.8% occurring in the first year and 81.3% occurring by year 5. The majority of recurrences were observed in the laser group (58.3%). The median (IQR) time to local recurrence was 15.9 (5.66-26.14) months. The 1- 2- and 5-year RFS rates were 88.4, 85.6 and 75%, respectively, and the median (IQR) RFS time was 106.5 (80.2-132.2) months. Conclusions Among patients with penile CIS selected for surgical management, durable responses at intermediate- to long-term follow-up were noted. For those with glandular CIS, glans resurfacing offered the best outcomes. CAPTION(S): Fig. S1 Overall survival based on recurrence status. Table S1 Univariable and multivariable Cox proportional hazard ratio (HR) for factors associated with local recurrence. Table S2 Management of local and regional recurrences.
    Keywords: Carcinoma In Situ ; Recurrence ; #Penilecancer
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 7
    Language: English
    In: Urology, November 2017, Vol.109, pp.140-144
    Description: To analyze the recurrence and survival outcomes of glansectomy in patients with penile squamous cell carcinoma. We performed a retrospective review of 410 patients across 5 international tertiary referral centers between 1999 and 2016. All patients had tumors involving the glans penis and underwent glansectomy as primary treatment. The Kaplan-Meier method and log-rank test were used to calculate survival and recurrence. Median follow-up was 42 months (interquartile range [IQR] 29-56). The median age was 64 years (IQR 53-72). Median tumor size was 2.2 cm (IQR 1.5-3.0). A total of 240 patients (58.5%) had pT2 disease, whereas only 43 patients (10.5%) had pT3 or pT4 disease. The majority of the cohort had poorly differentiated tumors (43.7%). Most recurrences were local at 7.6% (31 patients). Only 14 patients (3.4%) had regional recurrence and 9 patients (2.2%) had distant recurrence. When stratified by pathologic stage, tumors that were pT2 or higher were (  〈 .001) and were more likely to be poorly differentiated (  〈 .001). There were no differences in recurrence location among pathologic stages (  = .15). The 1-, 2-, and 5-year recurrence-free survival were 98%, 94%, and 78%, respectively. There were no differences in overall survival when stratified by stage (  = .67). Glansectomy is an oncologically safe treatment modality for squamous cell carcinoma of the glans in appropriately selected invasive tumors.
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 8
    Language: English
    In: Urologic Oncology: Seminars and Original Investigations, April 2018, Vol.36(4), pp.147-152
    Description: Although the trend towards penile sparing therapy is increasing for penile squamous cell carcinoma, outcomes for laser ablation therapy have not been widely reported. We assessed the clinical outcomes of penile cancer patients treated with only laser ablation. A retrospective review was performed on 161 patients across 5 multi-center tertiary referral centers from 1985 to 2015. All patients underwent penile sparing surgery with only laser ablation for squamous cell carcinoma of the penis. Laser ablation was performed with neodymium-doped yttrium aluminum garnet or carbon dioxide. Overall and recurrence-free survival was calculated using the Kaplan-Meier method and compared with the log rank test. A total of 161 patients underwent laser ablation for penile cancer. The median age was 62 (IQR: 52–71) years and median follow-up was 57.7 (IQR: 28–90) months. The majority of patients were pTa/Tis (59, 37%) or pT1a (62, 39%). Only 19 (12%) had a poorly differentiated grade. The 5-year recurrence-free survival was 46%. When stratified by stage, the 5-year local recurrence-free survival was pTa/Tis: 50%; pT1a: 41%; pT1b: 38%; and pT2: 52%. The inguinal/pelvic nodal recurrence was pTa/Tis: 2%; pT1a: 5%; pT1b: 18%; and pT2: 22%. There were no differences among stages with respect to recurrence-free survival ( = 0.98) or overall survival ( = 0.20). Laser ablation therapy is safe for appropriately selected patients with penile squamous cell carcinoma. Due to the increased risk of nodal recurrence, laser ablation coupled with diagnostic nodal staging is indicated for patients with pT1b or higher.
    Keywords: Laser Ablation ; Recurrence ; Penile Sparing Surgery ; Penile Squamous Cell Carcinoma ; Medicine
    ISSN: 1078-1439
    E-ISSN: 1873-2496
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