Neoadjuvant chemotherapy (NAC) has shown promising results in patients with locally advanced penile cancer. However, no consensus exists on its applications for locally advanced penile cancer. Thus, it is unclear which kind of chemotherapy regimen is the best choice. Consequently, a systematic search of PubMed, Web of Science, and EMBASE was performed in March 2021 to assess the efficacy and safety of NAC for the treatment of patients with locally advanced penile cancer. The Newcastle-Ottawa Scale was used to assess the risk of bias in each study. This study synthesized 14 published studies. The study revealed that patients who achieved an objective response to NAC obtained a better survival outcome compared with those who did not achieve an objective response. In addition, the objective response rates (ORRs) and pathological complete response (pCR) rates were 0.57 and 0.11, respectively. The incidence of grade ≥3 toxicity was 0.36. Subgroup analysis found that the ORR and pCR of the taxane-platinum (TP) regimen group performed better than those of the nontaxane-platinum (NTP) regimen group (0.57 vs 0.54 and 0.14 vs 0.07, respectively). Moreover, the TP regimen group had more frequent toxicity than the NTP regimen group (0.41 vs 0.26). However, further studies were warranted to confirm the findings.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Humans ; Male ; Neoadjuvant Therapy/methods* ; Penile Neoplasms/drug therapy* ; Platinum ; Treatment Outcome

Radical prostatectomy (RP) is preferred for many patients with clinically localized prostate cancer. Despite the introduction of the nerve sparing technique and progressive modifications on RP, postoperative preservation of penile erectile function remains a challenge to urologists. Earlier initiation of penile rehabilitation can significantly improve the patient's quality of life affected by erectile dysfunction (ED) following RP. Tadalafil, a long-acting PDE5 inhibitor with a unique clinical profile, has proved effective in penile rehabilitation in the treatment of RP-associated ED in both clinical trails and animal models. This article reviews current strategies for the management of ED after RP and evaluates the efficacy and safety of tadalafil in post-RP penile rehabilitation.
Carbolines ; therapeutic use ; Erectile Dysfunction ; drug therapy ; rehabilitation ; Humans ; Male ; Penile Erection ; Prostatectomy ; rehabilitation ; Prostatic Neoplasms ; rehabilitation ; surgery ; Tadalafil

Gadolinium ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Penile Neoplasms ; diagnosis ; diagnostic imaging ; drug therapy ; pathology ; Penis ; pathology ; Radionuclide Imaging

The phenomenon of multiple primary malignant tumors in one patient synchronously or metachronously is no more curiosity. So, careful follow up study and early diagnosis of those lesions, based on an awareness of the possibility of the second cancer, will substantially increase the survival of these patients. We collected nine cases of multiple primary cancers according to Moertel's classification histologically proved and treated from 1985 to l992 at Kosin Medical Center. The results were as follows; 1. The average age of the patients was 60.9 years with dominance in seventh decade 2. The male to female ratio was 7: 2 with significant dominance in male. 3. The synchronous to metachronous ratio was 6: 3, in metachronous cases the average time interval between 1st and 2nd cancers was 122 months. 4. In 6 cases of synchronous cancers, there were penile cancer and hepatoma, renal cell carcinoma and bladder cancer, prostatic cancer and bladder cancer, bladder cancer and colon cancer, and prostatic cancer and lung cancer. In 3 cases of metachronous cancers, there were bladder cancer and uterine cervical cancer, bladder cancer and stomach cancer, and renal cell carcinoma and synovial sarcoma. 5. In 3 cases of metachronous cancers, adjuvant therapy was performed in 2 cases after operation including one case of chemotherapy and another case of radiotherapy.
Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Classification ; Colonic Neoplasms ; Drug Therapy ; Early Diagnosis ; Exploratory Behavior ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Male ; Neoplasms, Second Primary ; Penile Neoplasms ; Prostatic Neoplasms ; Radiotherapy ; Sarcoma, Synovial ; Stomach Neoplasms ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms

PURPOSE: The aim of this study was to assess the clinicopathologic characteristics of penile cancer, including patterns of therapy, oncologic results, and survival. MATERIALS AND METHODS: Between January 2005 and July 2015, 71 patients at 6 institutions who had undergone penectomy or penile biopsy were enrolled. Their medical records were reviewed to identify the mode of therapy, pathology reports, and cancer-specific survival (CSS) rate. RESULTS: Clinicopathologic and outcome information was available for 52 male patients (mean age, 64.3 years; mean follow-up, 61.4 months). At presentation, 17 patients were node-positive, and 4 had metastatic disease. Management was partial penectomy in 34 patients, total penectomy in 12 patients, and chemotherapy or radiotherapy in 6 patients. The pathology reports were squamous cell carcinoma in 50 patients and other types of carcinoma in the remaining 2 patients. Kaplan-Meier survival analysis showed a 5-year CSS rate of 84.0%. In univariate and multivariate analyses, the American Joint Committee on Cancer (AJCC) stage and pathologic grade were associated with survival. CONCLUSIONS: Partial penectomy was the most common treatment of penile lesions. The oncologic outcomes were good, with a 5-year CSS of 84.0%. The AJCC stage and pathologic grade were independent prognostic factors for survival.
Biopsy ; Carcinoma, Squamous Cell ; Drug Therapy ; Follow-Up Studies ; Humans ; Joints ; Male ; Medical Records ; Multivariate Analysis ; Pathology ; Penile Neoplasms* ; Prognosis ; Radiotherapy ; Treatment Outcome

BACKGROUND: Penile cancer is a rare malignancy associated with high rates of mortality and morbidity. Currently, the efficacy of adjuvant treatment (AT), including radiotherapy and chemotherapy, for penile cancer remains unclear. Therefore, we investigated the prognostic factors for treatment outcomes and the efficacy of AT in consecutive patients who underwent penectomy for penile cancer at multiple Korean institutions between 1999 and 2013. METHODS: AT was defined as the administration of chemotherapy, radiotherapy, or both within 12 months after initial treatment. All patients were divided into two groups according to the AT status. RESULTS: Forty-three patients (median age 67.0 years) with a median follow-up after penectomy of 26.4 (interquartile range: 12.0–62.8) months were enrolled. Patients with AT had a significantly higher pathologic stage. However, no differences in age, histologic grade, or type of surgery were identified according to the presence of AT. The 3- and 5-year cancer-specific survival (CSS) rates were 79.0% and 33.0%, respectively. In a multivariate analysis, American Joint Committee on Cancer (AJCC) stage ≥ III disease was an independent predictor of CSS and recurrence-free survival (RFS). However, AT was not associated with CSS and RFS. The type of primary surgical treatment and inguinal lymph node dissection at diagnosis were also not significantly associated with overall survival, CSS, or RFS. CONCLUSION: AJCC stage ≥ III disease, which mainly reflects lymph node positivity, is a significant prognosticator in patients with penile cancer. By contrast, AT does not seem to affect CSS and RFS.
Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Humans ; Joints ; Lymph Node Excision ; Lymph Nodes ; Male ; Mortality ; Multivariate Analysis ; Penile Neoplasms* ; Prognosis ; Radiotherapy ; Radiotherapy, Adjuvant

The prognosis of locally advanced or recurrent squamous cell carcinoma (SCC) of the penis after conventional treatment is dismal. This study aimed to evaluate the therapeutic effects of intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced or recurrent SCC of the penis. Between April 1999 and May 2011, we treated 5 patients with locally advanced penile SCC and 7 patients with recurrent disease with intraarterial chemotherapy. The response rate and toxicity data were analyzed, and survival rates were calculated. After 2 to 6 cycles of intraarterial chemotherapy with gemcitabine and cisplatin, 1 patients with locoregionally advanced disease achieved a complete response, and 4 achieved partial response. Of the 7 patients with recurrent disease, 2 achieved complete response, 3 achieved partial response, 3 had stable disease, and 1 developed progressive disease. An objective tumor response was therefore achieved in 10 of the 12 patients. The median overall survival for the patients was 24 months (range, 10-50 months). Three out of 10 patients who responded were long-term survivors after intraarterial chemotherapy. Intraarterial chemotherapy with gemcitabine and cisplatin may be effective and potentially curative in locoregionally advanced or recurrent penile SCC. The contribution of this therapy in the primary management of advanced or recurrent penile SCC should be prospectively investigated.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; adverse effects ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease Progression ; Follow-Up Studies ; Humans ; Infusions, Intra-Arterial ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Penile Neoplasms ; drug therapy ; pathology ; Survival Rate

A 56-yr-old man with lung adenocarcinoma presented with subsegmental pulmonary thrombosis. Platelet count on presentation was 531x10(9)/L. The patient was anticoagulated with subcutaneous low molecular weight heparin (LMWH). Next day, oral anticoagulation was initiated with 5 mg of warfarin once daily with LMWH and LMWH was discontinued at third hospital day. On the third day of oral anticoagulation therapy, he complained of left leg swelling and prolonged painful penile erection of 24 hr-duration. His platelet count reached a nadir 164x10(9)/L at that time, and the patient had a deficiency of protein C and S, with an activity level of 16% and 20% of normal value. Warfarin was stopped and he underwent penile aspiration. The next day, left leg edema and penile erection was disappeared, but penile and glans penis necrosis was started. This case illustrates that processes underlying heparin-induced thrombocytopenia (HIT) may also underlie warfarin-induced skin necrosis.
Adenocarcinoma/complications/diagnosis ; Anticoagulants/*adverse effects ; Heparin/*adverse effects ; Humans ; Lung Neoplasms/complications/diagnosis ; Male ; Middle Aged ; Necrosis ; Penile Erection/drug effects ; Penis/*pathology ; Platelet Count ; Protein C/analysis ; Protein S/analysis ; Pulmonary Artery ; Thrombocytopenia/*chemically induced ; Thrombosis/complications/diagnosis/drug therapy ; Warfarin/*adverse effects