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Locally advanced penile carcinoma: classic emasculation or testis-sparing surgery?
International Braz J Urol; Gonzaga-Silva, Lúcio Flávio; Lima, George R. M.; Tavares, José M.; Pinheiro, Vladmir O.; Magalhães, George A.; Tomas, Manoel E.; Nogueira, Cleto D.; Lima, Marcos V. A..
  • Gonzaga-Silva, Lúcio Flávio; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Lima, George R. M.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Tavares, José M.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Pinheiro, Vladmir O.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Magalhães, George A.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Tomas, Manoel E.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Nogueira, Cleto D.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
  • Lima, Marcos V. A.; Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL). Ceará. BR
Int. braz. j. urol ; 38(6): 750-759, Nov-Dec/2012. tab, graf
Article in English | LILACS | ID: lil-666024
ABSTRACT
Purpose

id="para1">The study evaluates the clinical and pathological findings of 16 patients with locally advanced penile carcinoma (PC) submitted to emasculation, and discusses questions related to the usefulness of bilateral orchiectomy. Materials and <a class="decs" id="q000379">Methods</a>

id="para2">Between 1999 and 2010, 172 patients with PC were treated. Sixteen (9%) underwent emasculation. Data were retrieved from the institution's database including age, ethnicity, date of surgery, residential setting, level of schooling, time to diagnosis, type of reconstruction, complications, tumor stage and grade, vascular and perineural invasion along with invasion of corpus cavernosum, corpus spongiosum, testicles, scrotum and urethra. Results

id="para3">A total of 16 patients (average 63.1 years) with locally advanced PC were included. All were illiterate or semiliterate rural dwellers and 87% were white. The time to diagnosis was 8-12 months. The mean follow-up time was 31.9 months (1-119). By the time of the last follow-up, only seven patients (43.75%) were alive. Tumors were pT4 (n = 6), pT3 (n = 8), pT2 (n = 2), Grade I (n = 5) and Grade II (n = 11). The histopathological examination revealed invasion of the urethra (n = 13), scrotum (n = 5) and testicles (n = 1). The surgical margin was positive in one patient. Six patients (37.5%) had vascular invasion and 11 (68.7%) had perineural invasion. Currently, only one of the former is alive. Conclusions

id="para4">The finding of focal microscopic testicular infiltration in only one of 32 testicles, even in the presence of clinically apparent scrotal invasion, suggests that emasculation without bilateral orchiectomy is a safe treatment option for patients with locally advanced PC. .

Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Penile Neoplasms / Testis / Carcinoma, Squamous Cell / Orchiectomy Type of study: Evaluation studies / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL)/BR

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Full text: Available Index: LILACS (Americas) Main subject: Penile Neoplasms / Testis / Carcinoma, Squamous Cell / Orchiectomy Type of study: Evaluation studies / Observational study / Prognostic study Limits: Adult / Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2012 Type: Article Affiliation country: Brazil Institution/Affiliation country: Ceará Cancer Hospital (LFGS, JMT, VOP, GAM, MET, CDN, MVAL)/BR