Der Urologe

, Volume 57, Issue 4, pp 440–443 | Cite as

Lymphknotenpositives Peniskarzinom

Management und systemische Therapie
  • A. Aziz
  • S. Milerski
  • K. Kernig
  • C. Protzel
  • O. W. Hakenberg
Leitthema

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.

Schlüsselwörter

Metastasen Adjuvante Chemotherapie Strahlentherapie Lymphadenektomie Lymphknotenbiopsie Peniskarzinom Lymphknoten 

Lymph-node-positive penile cancer

Management and systemic therapy

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.

Keywords

Metastasis Adjuvant chemotherapy Radiotherapy Lymphadenectomy Lymph node biopsy Penile cancer Lymph node 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

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.

Literatur

  1. 1.
    Hakenberg OW, Compérat EM, Minhas S et al (2014) EAU guidelines on penile cancer: 2014 update. Eur Urol 67(1):142–150CrossRefPubMedGoogle Scholar
  2. 2.
    Brierley JD et al (2016) TNM classification of malignant tumours, 8. Aufl. International Union Against Cancer, Wiley-Blackwell, Hoboken, S 188–189Google Scholar
  3. 3.
    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 87:679–694PubMedGoogle Scholar
  4. 4.
    Protzel C et al (2009) Lymphadenectomy in the surgical management of penile cancer. Eur Urol 55:1075–1088CrossRefPubMedGoogle Scholar
  5. 5.
    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 54:161CrossRefPubMedGoogle Scholar
  6. 6.
    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 97:487CrossRefPubMedGoogle Scholar
  7. 7.
    Koifman L et al (2013) Radical open inguinal lymphadenectomy for penile carcinoma: surgical technique, early complications and late outcomes. J Urol 190:2086CrossRefPubMedGoogle Scholar
  8. 8.
    Yao K et al (2010) Modified technique of radical inguinal lymphadenectomy for penile carcinoma: morbidity and outcome. J Urol 184:546CrossRefPubMedGoogle Scholar
  9. 9.
    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 111:1068–1074CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    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 177:953CrossRefPubMedGoogle Scholar
  11. 11.
    Srinivas V, Morse MJ, Herr HW (1987) Penile cancer: relation of extent of nodal metastasis to survival. J Urol 137:880–882CrossRefPubMedGoogle Scholar
  12. 12.
    Pandey D, Mahajan V, Kannan RR (2006) Prognostic factors in node-positive carcinoma of the penis. J Surg Oncol 93:133–138CrossRefPubMedGoogle Scholar
  13. 13.
    Cabanas RM (1977) An approach for the treatment of penile carcinoma. Cancer 39:456CrossRefPubMedGoogle Scholar
  14. 14.
    Pizzocaro G et al (1988) Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27:823CrossRefPubMedGoogle Scholar
  15. 15.
    Leijte JA et al (2007) Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 52:488CrossRefPubMedGoogle Scholar
  16. 16.
    Bermejo C et al (2007) Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 177:1335CrossRefPubMedGoogle Scholar
  17. 17.
    Pizzocaro G et al (1997) Up-to-date management of carcinoma of the penis. Eur Urol 32:5PubMedGoogle Scholar
  18. 18.
    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 32:5Google Scholar
  19. 19.
    Hakenberg OW et al (2006) Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma. BJU Int 98:1225CrossRefPubMedGoogle Scholar
  20. 20.
    Haas GP et al (1999) Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol 161:1823CrossRefPubMedGoogle Scholar
  21. 21.
    Hussein AM et al (1990) Chemotherapy with cisplatin and 5‑fluorouracil for penile and urethral squamous cell carcinomas. Cancer 65:433CrossRefPubMedGoogle Scholar
  22. 22.
    Shammas FV et al (1992) Cisplatin and 5‑fluorouracil in advanced cancer of the penis. J Urol 147:630CrossRefPubMedGoogle Scholar
  23. 23.
    Pagliaro LC et al (2010) Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 28:3851CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Udager AM et al (2016) Frequent PD-L1 expression in primary and metastatic penile squamous cell carcinoma: potential opportunities for immunotherapeutic approaches. Ann Oncol 27:1706–1712CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Cocks M et al (2017) Immune-checkpoint status in penile squamous cell carcinoma: a North American cohort. Hum Pathol 59:55–61CrossRefPubMedGoogle Scholar
  26. 26.
    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 197:690–697CrossRefPubMedGoogle Scholar
  27. 27.
    Graafland NM et al (2011) Inguinal recurrence following therapeutic lymphadenectomy for node positive penile carcinoma: outcome and implications for management. J Urol 185:888CrossRefPubMedGoogle Scholar
  28. 28.
    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 26:123CrossRefPubMedGoogle Scholar
  29. 29.
    Franks KN et al (2011) Radiotherapy for node positive penile cancer: experience of the Leeds teaching hospitals. J Urol 186:524CrossRefPubMedGoogle Scholar
  30. 30.
    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 88:94CrossRefPubMedGoogle Scholar
  31. 31.
    Lucky MA et al (2009) Referrals into a dedicated British penile cancer centre and sources of possible delay. Sex Transm Infect 85:527CrossRefPubMedGoogle Scholar
  32. 32.
    Baumgarten AS et al (2014) Salvage surgical resection for isolated locally recurrent inguinal lymph node metastasis of penile cancer: international study collaboration. J Urol 192:760–764CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • A. Aziz
    • 1
  • S. Milerski
    • 1
  • K. Kernig
    • 1
  • C. Protzel
    • 2
  • O. W. Hakenberg
    • 1
  1. 1.Klinik und Poliklinik für UrologieUniversitätsmedizin RostockRostockDeutschland
  2. 2.Klinik für UrologieHelios-Klinikum SchwerinSchwerinDeutschland

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