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Mohs surgery may provide effective long-term local control for patients with localized penile cancer, according to a 10-year retrospective study presented at the Society of Urologic Oncology (SUO) 21st Annual Meeting.
The procedure demonstrated an overall survival (OS) of 97.7% and a relapse-free survival (RFS) of 93.0%.
Penile cancer is a rare malignancy with an annual incidence of 0.1 to 0.7 per 100,000 men, which represents less than 1% of male cancers in the United States. The treatment is associated with continuing mutilations in the quality of life of these patients, “Nicolas E. Alcalá, a fourth-year medical student at the University of North Carolina, said during a virtual presentation.” Therefore, organ-sparing approaches are on the rise “.
To maximize cancer control and minimize the psychological emotional impacts of surgery, treatment for penile cancer includes partial penectomy, local excision, topical chemotherapy, laser ablation, circumcision, glansectomy, and glans resurfacing.
However, Alcalá et al questioned whether Mohs’ microsurgery provided effective cancer control and localized penile cancer. Researchers created the REDCap database which examines patients from 2010 to 2020 with penile cancer at the University of North Carolina treated with Mohs microsurgery. Patients were seen in a multidisciplinary setting, including urological oncology, dermatology and reconstructive urology.
Patients with Ta, Tis, T1 and T2 disease were considered candidates for Mohs surgery.
Forty-three men who underwent Mohs surgery were identified using a prospectively managed database. Clinical and pathological data were collected for descriptive analysis.
Specifically, the researchers evaluated variables including demographics, risk factors, lesion location, tumor size, grade and stage. OS and RFS served as primary results.
Patients had a mean age of 64 years (range 23-83) and the majority were white (88.4%). The main risk factors were patients who were uncircumcised (23%) and those with a history of carcinoma in situ (23%).
The stage distribution was Ta in 4.7%, Tis in 58.1%, T1a in 14.0 %%, T1b in 7.0% and T2 in 16.3%. In total, 14% of patients reported Grade 1 disease, 14% Grade 2, 37.2% Grade 3, and 34.9% with disease of unknown degree. The lesions were mainly localized on the glans (41.9%).
No patient had a positive surgical margin after Mohs surgery. RFS was 93.0%, with 3 patients (7%) relapsing. Of those with relapse, 2 patients experienced local relapse within 6 months, were treated with local resection and Tis were found, while 1 patient with T1b disease had T1bN2 relapse at 2 years and was treated with paclitaxel, ifosfamide and cisplatin.
OS was 97.7%, with 1 death from non-cancer related causes.
“Mohs’ microsurgery provides effective local control for localized penile cancer. A multidisciplinary team involving urological oncology, reconstructive oncology and Mohs surgery is essential for patient management, “concluded Alcalá, adding that he and his colleagues will finalize the findings by looking at the quality of sexual, urinary and general health related.
Reference:
Alcalá NE, Reines KL, Merritt B, Figler B, Bjurlin M. Oncologic Outcomes of Mohs Surgery for Localized Penile Carcinoma: A 10-Year Retrospective Study. Presented at: 21st Annual Meeting of the Society of Urologic Oncology; 3 December 2020 Abstract 7.
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