Zusammenfassung
Für das karzinomspezifische Überleben von Männern mit Peniskarzinom sind Lymphknotenmetastasierung (LKM) und deren Ausmaß der wichtigste prognostische Faktor. Patienten mit begrenzten inguinalen LKM erreichen zwar im günstigsten Fall 5‑Jahres-Überlebensraten von bis zu 80 %, aber solche mit pelvinen LKM und/oder Fernmetastasen erreichen nur 5‑Jahres-Überlebensraten von 0–33 %. In jedem Fall ist bei Patienten mit regionären LKM therapeutisch ein multimodales Vorgehen mit operativer Therapie und adjuvanter Chemotherapie indiziert.
Abstract
Cancer-specific survival in men with penile cancer depends foremost on regional lymphatic metastasis and its extent. Patients with limited inguinal lymph node metastases have a 5-year survival of up to 80%. However, those with pelvic lymph node metastases and/or systemic disease have a 5-year survival prognosis of only 0–33%. In any case, in patients with regional lymph node metastases multimodal treatment with complete lymphadenectomy and adjuvant chemotherapy is indicated.
Literatur
Hakenberg OW, Compérat EM, Minhas S et al (2014) EAU guidelines on penile cancer: 2014 update. Eur Urol 67(1):142–150
Brierley JD et al (2016) TNM classification of malignant tumours, 8. Aufl. International Union Against Cancer, Wiley-Blackwell, Hoboken, S 188–189
Daseler EH, Anson BJ, Reimann AF (1948) Radical excision of the inguinal and iliac lymph glands; a study based upon 450 anatomical dissections and upon supportive clinical observations. Surg Gynecol Obstet 87:679–694
Protzel C et al (2009) Lymphadenectomy in the surgical management of penile cancer. Eur Urol 55:1075–1088
Leijte JA et al (2008) Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a two-centre analysis of 700 patients. Eur Urol 54:161
Ornellas AA et al (2008) Surgical treatment of invasive squamous cell carcinoma of the penis: Brazilian National Cancer Institute long-term experience. J Surg Oncol 97:487
Koifman L et al (2013) Radical open inguinal lymphadenectomy for penile carcinoma: surgical technique, early complications and late outcomes. J Urol 190:2086
Yao K et al (2010) Modified technique of radical inguinal lymphadenectomy for penile carcinoma: morbidity and outcome. J Urol 184:546
Matin SF et al (2013) Phase 1 prospective evaluation of the oncological adequacy of robotic assisted videoendoscopic inguinal lymphadenectomy in patients with penile carcinoma. BJU Int 111:1068–1074
Tobias-Machado M et al (2007) Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma. J Urol 177:953
Srinivas V, Morse MJ, Herr HW (1987) Penile cancer: relation of extent of nodal metastasis to survival. J Urol 137:880–882
Pandey D, Mahajan V, Kannan RR (2006) Prognostic factors in node-positive carcinoma of the penis. J Surg Oncol 93:133–138
Cabanas RM (1977) An approach for the treatment of penile carcinoma. Cancer 39:456
Pizzocaro G et al (1988) Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27:823
Leijte JA et al (2007) Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 52:488
Bermejo C et al (2007) Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 177:1335
Pizzocaro G et al (1997) Up-to-date management of carcinoma of the penis. Eur Urol 32:5
Giannatempo P et al (2014) Survival analyses of adjuvant or neoadjuvant combination of a taxane plus cisplatin and 5‑fluorouracil (T-PF) in patients with bulky nodal metastases from squamous cell carcinoma of the penis (PSCC): results of a single high-volume center. J Clin Oncol 32:5
Hakenberg OW et al (2006) Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma. BJU Int 98:1225
Haas GP et al (1999) Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol 161:1823
Hussein AM et al (1990) Chemotherapy with cisplatin and 5‑fluorouracil for penile and urethral squamous cell carcinomas. Cancer 65:433
Shammas FV et al (1992) Cisplatin and 5‑fluorouracil in advanced cancer of the penis. J Urol 147:630
Pagliaro LC et al (2010) Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 28:3851
Udager AM et al (2016) Frequent PD-L1 expression in primary and metastatic penile squamous cell carcinoma: potential opportunities for immunotherapeutic approaches. Ann Oncol 27:1706–1712
Cocks M et al (2017) Immune-checkpoint status in penile squamous cell carcinoma: a North American cohort. Hum Pathol 59:55–61
Ottenhof SR et al (2017) Expression of programmed death ligand 1 in penile cancer is of prognostic value and associated with HPV status. J Urol 197:690–697
Graafland NM et al (2011) Inguinal recurrence following therapeutic lymphadenectomy for node positive penile carcinoma: outcome and implications for management. J Urol 185:888
Kulkarni JN et al (1994) Prophylactic bilateral groin node dissection versus prophylactic radiotherapy and surveillance in patients with N0 and N1-2A carcinoma of the penis. Eur Urol 26:123
Franks KN et al (2011) Radiotherapy for node positive penile cancer: experience of the Leeds teaching hospitals. J Urol 186:524
Burt LM et al (2014) Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys 88:94
Lucky MA et al (2009) Referrals into a dedicated British penile cancer centre and sources of possible delay. Sex Transm Infect 85:527
Baumgarten AS et al (2014) Salvage surgical resection for isolated locally recurrent inguinal lymph node metastasis of penile cancer: international study collaboration. J Urol 192:760–764
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A. Aziz, S. Milerski, K. Kernig, C. Protzel undO. W. Hakenberg geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
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Aziz, A., Milerski, S., Kernig, K. et al. Lymphknotenpositives Peniskarzinom. Urologe 57, 440–443 (2018). https://doi.org/10.1007/s00120-018-0601-y
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DOI: https://doi.org/10.1007/s00120-018-0601-y
Schlüsselwörter
- Metastasen
- Adjuvante Chemotherapie
- Strahlentherapie
- Lymphadenektomie
- Lymphknotenbiopsie
- Peniskarzinom
- Lymphknoten