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Background and objective: Nodal metastasis is a major survival and prognostic factor in penile cancer (PeCa). Thus, accurate staging, prognosis, and treatment selection require adequate inguinal lymphadenectomy (ILND). ILND surgery should balance oncologic rigor with morbidity and postoperative complications. Our aim was to compare the feasibility and safety of open ILND (OILND) and videoendoscopic ILND (VEILND) in patients with PeCa. Methods: We conducted a single-center randomized trial with a within-patient design between October 2019 and April 2023. Patients who were undergoing either staging or radical ILND for PeCa were included and randomized to receive either OILND or VEILND on one side, with the other technique then used on the contralateral side. The trial was approved by the local ethics committee and was registered on ClinicalTrials.gov (NCT05887921). The primary outcome was the safety of VEILND. Secondary outcomes included intraoperative and postoperative morbidity rates and surgical outcomes for the two procedures, as well as oncological outcomes according to survival estimates. Key findings and limitations: We included 14 patients in the study. Median follow-up was 12 mo (interquartile range [IQR] 12–17). There were no significant differences in operative time and the number of lymph nodes removed between OILND and VEILND. However, the median time to drain removal was significantly shorter in the VEILND group (15 d, IQR 13–17, 95% confidence interval [CI] 12–17) than in the OILND group (27 d, IQR 20–41, 95% CI 24–31; p = 0.025). No intraoperative complications were observed, but postoperative complications occurred in three cases (21.4%, 95% CI 8.4–37.8%) in the VEILND group and eight (57.1%, 95% CI 18.6–54.3%) in the OILND group (p = 0.032). Conclusions and clinical implications: VEILND represents a safe technique to consider for either staging or curative intent in PeCa and seems to have an advantage over OILND in terms of morbidity. Further high-powered studies are warranted to confirm these preliminary results. Patient summary: We compared the outcomes of two different surgical techniques to remove lymph nodes in patients with penile cancer. We found that a video-assisted keyhole surgery approach seems to result in a lower rate of complications than after open surgery.

Abstract Background Penile cancer is a rare male genital malignancy. Surgical excision of the primary tumour is followed by radical inguinal lymphadenectomy if there is metastatic disease detected by biopsy, fine needle aspiration cytology (FNAC) or following sentinel lymph node biopsy in patients with impalpable disease. However, radical inguinal lymphadenectomy is associated with a high morbidity rate, and there is increasing usage of a videoendoscopic approach as an alternative. Methods A pragmatic, UK-wide multicentre feasibility randomised controlled trial (RCT), comparing videoendoscopic radical inguinal lymphadenectomy versus open radical inguinal lymphadenectomy. Patients will be identified and recruited from supraregional multi-disciplinary team meetings (sMDT) and must be aged 18 or over requiring inguinal lymphadenectomy, with no contraindications to surgical intervention for their cancer. Participants will be followed up for 6 months following randomisation. The primary outcome is the ability to recruit patients for randomisation across all selected sites and the rate of loss to follow-up. Other outcomes include acceptability of the trial and intervention to patients and healthcare professionals assessed by qualitative research and obtaining resource utilisation information for health economic analysis. Discussion There are currently no other published RCTs comparing videoendoscopic versus open radical inguinal lymphadenectomy. Ongoing study is required to determine whether randomising patients to either procedure is feasible and acceptable to patients. The results of this study may determine the design of a subsequent trial. Trial registration Clinicaltrials.gov PRS registry, registration number NCT05592639. Date of registration: 13th October 2022, retrospectively registered

Abstract Background Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed as a malignant tumor. While fasciitis ossificans commonly originates from the subcutaneous tissue and can appear throughout the body, it may also arise from extraordinary sites. Case presentation We report the first-ever documented case of fasciitis ossificans arising from the penis in a male patient who presented with a tumor on the glans penis. The tumor was surgically resected due to suspicion of penile cancer. Initial histopathological analysis led to a misdiagnosis of squamous cell carcinoma. However, pathological consultation ultimately confirmed the diagnosis of fasciitis ossificans of the penis originating from the glans penis by demonstrating ossification. Conclusion This case underscores the importance of considering fasciitis ossificans in the differential diagnosis of soft tissue tumors, even in unusual locations such as penile soft tissue.

Background: Palmar-plantar erythrodysesthesia (PPE) is a slowly developing cutaneous reaction commonly experienced by patients treated with fluoropyrimidines. While erythrodysesthesia normally presents in a palmar-plantar distribution, it can also present with genital involvement, but this presentation is likely underreported and incorrectly attributed to an acute reaction from radiation therapy. This article aims to define erythrodysesthesia of the penis and scrotum as a rare but significant side effect of capecitabine. Case presentation: We identified five cases of moderate to severe penis and scrotal erythrodysesthesia over a 2-year period at a large tertiary cancer center, representing an estimated incidence of 3.6% among male patients with rectal cancer who were treated with fluoropyrimidine-based chemoradiation within our institution. Conclusions: Improved understanding of erythrodysesthesia involving the penis and scrotum can facilitate early identification and treatment of symptoms, and possibly prevent the discontinuation or delay of cancer treatment in patients treated with capecitabine and similar drugs. These clinical advances would improve and prolong patient quality of life during cancer treatment and prevent complications that result in hospitalization. [ABSTRACT FROM AUTHOR]

Background: Data on the incidence and comorbidity of Lichen sclerosus (LS), based on validated nationwide population-based registries, remains scarce. Objective: To explore the incidence and association of comorbidities with LS in Sweden, emphasizing its potential links to malignancies and autoimmune disorders. Methods: A population-based retrospective open cohort study was conducted using the National Patient Register to identify all individuals diagnosed with LS (ICD-10 code L90.0) from 1 January 2001 to 1 January 2021. The study included 154,424 LS patients and a sex and age matched control group of 463,273 individuals to assess the incidence and odds ratios for various cancers and premalignant conditions. Results: The incidence of LS in Sweden was 80.9 per 100,000 person per year, with higher incidence in females (114.4) than in males (47.2). LS patients showed an increased odds ratio for vulvar cancer (OR = 8.3; 95% CI = 7.5–9.0), penile cancer (OR = 8.9; 95% CI = 7.3–11.0), prostate cancer (OR = 1.2; 95% CI = 1.1–1.2), testicular cancer (OR = 1.4; 95% CI = 1.1–1.7), bladder cancer (OR = 1.1; 95% CI = 1.1–1.2), breast cancer (OR = 1.4; 95% CI = 1.3–1.4), leukoplakia of the vulva (OR = 253.5; 95% CI = 221.9–289.6), and leukoplakia of the penis (OR = 5.1; 95% CI = 4.9–5.4). Conclusions: This study underscores the significantly increased association of various cancers and premalignant conditions in LS patients, highlighting the critical need for efficacious treatment and diligent follow-up. The association between LS and autoimmune diseases further necessitates comprehensive investigation to understand the underlying mechanisms and clinical management implications. Future research is essential to confirm these findings and elucidate the role of LS in cancer development. [ABSTRACT FROM AUTHOR]

Objective: To evaluate penile squamous cell carcinoma (PSCC) incidence and centralisation trends in the Netherlands over the past three decades, as well as the effect of centralisation of PSCC care on survival. Patients and methods: In the Netherlands PSCC care is largely centralised in one national centre of expertise (Netherlands Cancer Institute [NCI], Amsterdam). For this study, the Netherlands Cancer Registry, an independent nationwide cancer registry, provided per‐patient data on age, clinical and pathological tumour staging, follow‐up, and vital status. Patients with treatment at the NCI were identified and compared to patients who were treated at all other centres. The age‐standardised incidence rate was calculated with the European Standard Population. The probability of death due to PSCC was estimated using the relative survival. Multivariable Cox regression analysis was performed to evaluate predictors of survival. Results: A total of 3160 patients were diagnosed with PSCC between 1990 and 2020, showing a rising incidence (P < 0.001). Annual caseload increased at the NCI (1% in 1990, 65% in 2020) and decreased at other (regional) centres (99% to 35%). Despite a relatively high percentage of patients with T2–4 (64%) and N+ (33%) at the NCI, the 5‐year relative survival was higher (86%, 95% confidence interval [CI] 82–91%) compared to regional centres (76%, 95% CI 73–80%, P < 0.001). Patients with a pathological T2 tumour were treated with glans‐sparing treatment more often at the reference centre than at the regional centres (16% vs 5.0%, P < 0.001). After adjusting for age, histological grading, T‐stage, presence of lymph node involvement and year of diagnosis, treatment at regional centres remained a predictor for worse survival (hazard ratio 1.22, 95% CI 1.05–1.39; P = 0.006). Conclusion: The incidence of PSCC in the Netherlands has been gradually increasing over the past three decades, with a noticeable trend towards centralisation of PSCC care and improved relative survival rate. [ABSTRACT FROM AUTHOR]

Background: Penile squamous cell carcinoma (PSCC) is a rare disease that is more prevalent in developing countries, such as Brazil, and is linked to poor genital hygiene, which promotes the proliferation of microorganisms. Dysbiosis has an effect on the local immune response, increases the risk of viral infection, and can generate inflammatory processes. Current knowledge of the microbiota found in penile tissues is limited, and the bacterial diversity of the PSCC remains unknown. In this investigation, the microbiota associated with penile cancer and its potential role in tumor development and progression were identified. Methods: The 16S rRNA gene was analyzed by next‐generation sequencing in 19 tumors and their respective non‐tumor adjacent tissues to perform taxonomic classification, analysis of core microbiome, abundance, and diversity of amplicon sequence variants (ASVs) (QIIME2 v.2020.2), and in silico functional prediction (PICRUST2, p < 0.05). Results: In both tissues, the phyla Proteobacteria and Firmicutes, and genera Alcaligenes and Fusobaterium, were the most prevalent. Tumors presented a greater relative abundance of Fusobacteriota, Campilobacteria, and Fusobacterium (p = 0.04, p = 0.04, and p = 0.039, respectively). In addition, the beta diversity analysis revealed a tendency for the formation of two distinct groups when only advanced tumors (pT2 and pT3) were considered. Further, the functional analysis identified the top 35 pathways, and 79.5% of PSCC samples contained pro‐inflammatory microorganisms. Conclusion: We describe the first microbiome of penile carcinoma, which revealed an abundant and diverse microbiota as well as inflammatory‐related taxa (the phyla Proteobacteria and Firmicutes, the genera Fusobacterium and Prevotella, and the species Finegoldia magma and Pseudomonas geniculata) and molecular pathways (chitin derivates degradation, the protocatechuic acid pathway, inositol metabolism, and the sucrose pathway), which have also been linked to inflammation and carcinogenesis. Moreover, we found specific and abundant ASVs in both tumor and non‐tumor tissues. Our data encourage further study to better understand the role of these microorganisms in penile carcinogenesis, offering an opportunity for advances in diagnosis, prognosis, and early therapy. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV), an oncogenic DNA virus, is the most common sexually transmitted virus and significant public health concern globally. Despite the substantial prevalence of HPV infection among men, routine testing remains elusive due to the lack of approved HPV tests and the complexity of detection methods. Various studies have explored the link between HPV and genitourinary cancers, revealing different associations influenced by geographic variation, histological subtype and methodological differences. These findings underscore the importance of further research to elucidate the role of HPV in male urogenital cancers. This comprehensive review delves into the intricate relationship between HPV and male genitourinary cancers, shedding light on the virus's oncogenic mechanisms and its reported prevalence. A deeper understanding of HPV's implications for male health is essential for advancing public health initiatives and reducing the burden of urogenital cancers worldwide. [ABSTRACT FROM AUTHOR]

Penile squamous cell carcinoma (PSCC) occurs more frequently in some developing countries compared to developed countries. Infection with HIV and/or high-risk human papillomavirus (hrHPV) are risk factors for penile cancer development. The tumor microenvironment of PSCC may predict prognosis and may inform on the best targets for immunotherapy. We evaluated the immune microenvironment of penile tumors histologically, and determined whether and/or how HIV and/or hrHPV infections affect this tumor microenvironment. We conducted a prospective analytical cross-sectional study in which penile cancer tumors from 35 patients presenting at the University Teaching Hospital in Lusaka, Zambia were histologically staged and assessed for presence of tumor infiltrating immune cells and expression of immune checkpoints. Immunohistochemistry was used to evaluate immune checkpoints and infiltrating immune cells, while multiplex real-time polymerase chain reaction was used for hrHPV genotyping. The median age of all participants was 55 years. About 24% had advanced histological stage, 83% were HIV+, and 63% had hrHPV detected in their tumors using multiplex real-time polymerase chain reaction. PDL1 expression was significantly higher in HIV- participants than HIV+ participants (p = 0.02). Tumors with multiple hrHPV infections had a significantly higher number of cells expressing TIM3 than those with one hrHPV (p = 0.04). High grade tumors had a significantly higher infiltrate of FoxP3+ cells (p = 0.02), CD68+ cells (p = 0.01), CD163+ cells (p = 0.01), LAG3+ cells (p = 0.01), PD1+ cells (p = 0.01) and TIM3+ cells (p = 0.03) when compared with low grade tumours. There was significant moderate to strong positive correlation of cells expressing PD1 and LAG3 (⍴ = 0.69; p = 0.0001), PD1 and TIM3 (⍴ = 0.49; p = 0.017) and TIM3 and LAG3 PDL1 (⍴ = 0.61; p = 0.001). In conclusion, the tumor microenvironment of penile squamous cell carcinoma seems to be affected by both HIV and HPV infections. TIM3 appears to be a potential therapeutic target in PSCC patients with hrHPV infections. [ABSTRACT FROM AUTHOR]

This document contains abstracts summarizing various research studies in the field of surgical oncology. The abstracts cover a range of topics, including the impact of surgical treatment for glioblastoma on quality of life, the use of patient-derived organoids in tailoring chemotherapy for peritoneal cancer, the effects of postoperative morbidity on quality of life after pelvic exenteration, and the role of psychological prehabilitation in cancer surgery. Other abstracts discuss the accuracy of radiological peritoneal cancer index, the power of prehabilitation, and the use of indocyanine green in mapping lymph node involvement. Additionally, there are case reports and literature reviews on rare and aggressive malignancies, such as undifferentiated carcinoma with rhabdoid features and gastrointestinal clear cell sarcoma. The abstracts provide valuable insights into surgical oncology and highlight the need for further research and collaboration in the field. [Extracted from the article]

Objective: To investigate the predictive value of three preoperative inflammatory markers for lymph node metastasis in patients with pT1a stage penile squamous carcinoma without palpable inguinal lymph nodes. Methods: Clinical data of 103 patients with pT1a stage penile squamous carcinoma admitted to the First Affiliated Hospital of Soochow University and Taixing People’s Hospital from January 2012 to June 2023 were collected. Patients were divided into lymph node metastasis group and non⁃lymph node metastasis group based on postoperative pathological findings of inguinal lymph node involvement. Differences in age, body mass index (BMI), hypertension, diabetes mellitus, tumor diameter, neutrophil⁃to⁃lymphocyte ratio (NLR), platelet⁃to⁃lymphocyte ratio (PLR), lymphocyte⁃to⁃monocyte ratio (LMR), and postoperative pathological grading were compared between the two groups. Independent risk factors for lymph node metastasis were screened using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curves were performed to compare the predictive value of inflammatory markers for lymph node metastasis in patients with pT1a stage penile squamous carcinoma, and the predictive efficacy of each inflammatory markersfor lymph node metastasis was evaluated after adjusting sensitivity to 100%. Results: There were 24 cases (23.3%) in the inguinal lymph node metastasis group and 79 cases (76.7%) in the non-lymph node metastasis group. The differences between the two groups were statistically significant in terms of NLR (P < 0.001), PLR (P=0.035), and LMR (P < 0.001). Multivariate-analysis showed that NLR (P= 0.045) and LMR (P=0.021) were independent risk factors for inguinal lymph node metastasis in pT1a stage penile cancer. ROC curve analysis results showed that the area under the curve for NLR, LMR, and NLR+LMR were 0.833, 0.816, and 0.835 respectively. The optimal cut⁃off value for NLR was 2.33, with a sensitivity of 95.8% and a specificity of 68.4%; the optimal cut⁃off value for LMR was 3.80, with a sensitivity of 79.2% and a specificity of 78.5%; the sensitivity and specificity of combined detection of NLR+LMR were 83.3% and 74.7%, respectively. When adjusting sensitivity to 100%, the specificity of NLR and LMR for predicting inguinal lymph node metastasis in pT1a stage peniles quamous carcinoma was 50.6% and 2.5%, with cut⁃off values of 1.79 and 11.01. Conclusion: NLR and LMR are independent predictive factors for inguinal lymph node metastasis in pT1a stage penile squamous carcinoma. NLR> 2.33 and LMR＜3.80 suggest that patients are at great risk of lymph node metastasis, and lymph node dissection surgery is recommended to improve patient survival. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is a common sexually transmitted virus that can cause cervical cancer and other diseases. Dynamic transmission models (DTMs) have been developed to evaluate the health and economic impacts of HPV vaccination. These models typically include many parameters, such as natural history of the disease, transmission, demographic, behavioral, and screening. To ensure the accuracy of DTM projections, it is important to parameterize them with the best available evidence. This study aimed to identify and synthesize data needed to parametrize DTMs on the natural history of HPV infection and related diseases. Parameters describing data of interest were grouped by their anatomical location (genital warts, recurrent respiratory papillomatosis, and cervical, anal, vaginal, vulvar, head and neck, and penile cancers), and natural history (progression, regression, death, cure, recurrence, detection), and were identified through a systematic literature review (SLR) and complementary targeted literature reviews (TLRs). The extracted data were then synthesized by pooling parameter values across publications, and summarized using the range of values across studies reporting each parameter and the median value from the most relevant study. Data were extracted and synthesized from 223 studies identified in the SLR and TLRs. Parameters frequently reported pertained to cervical cancer outcomes, while data for other anatomical locations were less available. The synthesis of the data provides a large volume of parameter values to inform HPV DTMs, such as annual progression rates from cervical intraepithelial neoplasia (CIN) 1 to CIN 2+ (median of highest quality estimate 0.0836), CIN 2 to CIN 3+ (0.0418), carcinoma in situ (CIS) 2 to local cancer+ (0.0396), and regional to distant cancer (0.0474). Our findings suggest that while there is a large body of evidence on cervical cancer, parameter values featured substantial heterogeneity across studies, and further studies are needed to better parametrize the non-cervical components of HPV DTMs. [ABSTRACT FROM AUTHOR]

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Purpose: Populations with high cancer risk that are targeted for screening, education, and vaccination have been shown to increase rates of screening, which ultimately may improve timing of diagnosis and overall outcome for certain cancers. Spatial scan analysis provides a visual representation of areas with higher rates of disease. Limited research has used this methodology to assess HPV-associated cancers. Using, spatial scan statistics, our goal was to identify regions within Kentucky having significantly higher rates of HPV-associated tumors. These regions can be targeted for public health efforts in the form of education, vaccination, screening, and physician recruitment. Methods: The Kentucky Cancer Registry data from 1995 to 2016 and spatial scan statistics were used to identify county-level clusters with high-incidence of HPV-associated cancers after adjustment for age and sex. Anatomic sites included in this analysis were oropharynx, cervix, anus, penis, and vulva. Results: There was one high-rate cluster of oropharyngeal cancer, which was observed in the Louisville metropolitan region (Relative Risk [RR] = 1.24, p < 0.001). One high-rate cluster of anal and penile cancer incidence in men was identified that partially overlapped with the oropharyngeal cluster. There were five clusters of higher cervical, vulvar, and anal cancer incidence in females, one of which overlapped with the oropharyngeal cluster. Conclusion: Overlapping clusters of HPV-associated cancers were identified at the county-level and included both urban and rural counties of Kentucky. Findings can assist in the design of public health interventions to increase screenings, promote vaccination, and recruit physicians in these regions to improve prevention, diagnosis, and early treatment of HPV-associated cancers. [ABSTRACT FROM AUTHOR]

Background: Penile cancer is a rare male genital malignancy. Surgical excision of the primary tumour is followed by radical inguinal lymphadenectomy if there is metastatic disease detected by biopsy, fine needle aspiration cytology (FNAC) or following sentinel lymph node biopsy in patients with impalpable disease. However, radical inguinal lymphadenectomy is associated with a high morbidity rate, and there is increasing usage of a videoendoscopic approach as an alternative. Methods: A pragmatic, UK-wide multicentre feasibility randomised controlled trial (RCT), comparing videoendoscopic radical inguinal lymphadenectomy versus open radical inguinal lymphadenectomy. Patients will be identified and recruited from supraregional multi-disciplinary team meetings (sMDT) and must be aged 18 or over requiring inguinal lymphadenectomy, with no contraindications to surgical intervention for their cancer. Participants will be followed up for 6 months following randomisation. The primary outcome is the ability to recruit patients for randomisation across all selected sites and the rate of loss to follow-up. Other outcomes include acceptability of the trial and intervention to patients and healthcare professionals assessed by qualitative research and obtaining resource utilisation information for health economic analysis. Discussion: There are currently no other published RCTs comparing videoendoscopic versus open radical inguinal lymphadenectomy. Ongoing study is required to determine whether randomising patients to either procedure is feasible and acceptable to patients. The results of this study may determine the design of a subsequent trial. Trial registration: Clinicaltrials.gov PRS registry, registration number NCT05592639. Date of registration: 13th October 2022, retrospectively registered [ABSTRACT FROM AUTHOR]

Background: Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed as a malignant tumor. While fasciitis ossificans commonly originates from the subcutaneous tissue and can appear throughout the body, it may also arise from extraordinary sites. Case presentation: We report the first-ever documented case of fasciitis ossificans arising from the penis in a male patient who presented with a tumor on the glans penis. The tumor was surgically resected due to suspicion of penile cancer. Initial histopathological analysis led to a misdiagnosis of squamous cell carcinoma. However, pathological consultation ultimately confirmed the diagnosis of fasciitis ossificans of the penis originating from the glans penis by demonstrating ossification. Conclusion: This case underscores the importance of considering fasciitis ossificans in the differential diagnosis of soft tissue tumors, even in unusual locations such as penile soft tissue. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the safety and efficacy of indocyanine green (ICG) fluorescence‐guided inguinal lymph node dissection (ILND) in patients with penile cancer. Patients and Methods: A prospective, single‐blind, randomised controlled clinical trial (ChiCTR2100044584) was performed among patients with penile caner who underwent bilateral modified ILND at four centres in China between 1 April 2021 and 30 June 2022. Patients aged 18–80 years and diagnosed with squamous cell carcinomas were included. Each enrolled patient was randomly assigned to either ICG fluorescence‐guided ILND by a laparoscopic or robot‐assisted approach in one groin, with non‐ICG fluorescence‐guided ILND in the other groin acting as a control. The primary outcome was the number of retrieved ILNs. Secondary outcomes included complications according to the Clavien–Dindo classification and the ILN non‐compliance (inadequate removal of ILNs) rate. Results: A total of 45 patients were included in the intention‐to‐treat (ITT) analysis, and the 42 who completed the entire study were included in the per protocol (PP) analysis. There were no ICG‐related complications in any of the patients. The results of the ITT and PP analyses indicated that the total number of unilateral ILNs retrieved was higher on the ICG side than on the non‐ICG side (mean 13 vs 9 ILNs, difference 4 ILNs [95% CI 2.7–4.4], P = 0.007), and the number of unilateral deep and superficial ILNs was higher on the ICG side. Furthermore, the LN non‐compliance rate was lower on the ICG side than on the non‐ICG side. Additionally, there was no significant difference in local complications in the groins between the two sides (P > 0.05). Conclusion: An ICG fluorescence‐guided ILND was safe for patients with penile cancer. This procedure can improve the number of ILNs retrieved and reduce the LN non‐compliance rate without increased complications. ICG fluorescence‐guided ILND is beneficial and recommended for selected patients with penile cancer. [ABSTRACT FROM AUTHOR]

Surveillance is the standard management in low-risk cN0 penile squamous cell carcinoma (peSCC) patients. We report on main oncological outcomes of a series of low-risk cN0 peSCC patients. Patients underwent primary tumor surgery and either observation or dynamic sentinel node biopsy. Observation is a safe and effective management for low-risk peSCC patients. Younger patients may be offered a mini-invasive staging. Introduction: Surveillance is the standard management in low-risk cN0 penile squamous cell carcinoma (peSCC) patients. However, no previous analysis focused on early and long-term outcomes of these patients. We report on main oncological outcomes of a large series of low-risk cN0 peSCC patients. Patients and Methods: Between 1980 and 2017 included, 93 evaluable consecutive low-risk (ie, pT1a G1 cN0M0) peSCC patients underwent primary tumor surgery and either observation (74) or dynamic sentinel node biopsy (DSNB) (19) following a clinical diagnosis of T1 in 66 (71%), T2 in 15 (16.1%) and Tx in 12 (12.9%) patients, respectively. The statistical significance of differences in medians and proportions was tested with the Kruskal-Wallis and chi-square tests. Kaplan-Meier plots illustrated 5-year inguinal relapse (IR)-free survival rates. Results: Median age was 60 years (IQR: 50-69 years). Median follow-up was 92 months (IQR 54-133 months). Surveillance was more frequently adopted in clinical (c)T1 than in cT2 tumors (79.7% vs. 36.8%). None of 19 patients who had DSNB had nodal metastasis. Overall, 7 (7.5%) out of 93 pT1aG1cN0 peSCC patients had IR after a median interval of 9 months. Of note, 1 patient only relapsed after 12 months of surveillance. After stratification according to IR, relapses occurred more frequently in younger patients (59 vs. 64 years, P < .001). The 5-year IR-free survival rates for the entire cohort was 92% (95% Confidence interval [CI] 87-98%). Conclusions: Observation is a safe and effective management for low-risk peSCC patients. Younger patients may be offered a miniinvasive staging as an alternative. [ABSTRACT FROM AUTHOR]

Simple Summary: Penile cancer is a rare but aggressive squamous cell carcinoma affecting the male genitalia. Accounting for less than 1% of male malignancies in the U.S., it primarily manifests in the sixth decade of life. Penile cancer's psychological impact extends beyond diagnosis, encompassing the consequences of treatment and unique cancer-related distress. Treatment approaches range from organ-sparing techniques to more extensive surgeries, impacting sexual function and quality of life. Providing essential psychosocial support involves recognizing and managing emotional stress without stigmatizing it as pathological. Here we summarize studies assessing post-treatment outcomes, including quality of life, psychosocial effects, urinary symptoms, and sexual function. Patients' voices reveal unmet needs, emphasizing the importance of timely diagnosis, treatment access, and individualized psychosocial support. Treatment of penile cancer (PC) focuses on organ preservation, employing various surgical and non-surgical approaches. These interventions may lead to disfigurement, impacting patients' functional outcomes and psychosocial well-being. We reviewed studies related to penile health and PC up to February 2024, limited to studies published in English. Studies employing health-related quality of life (HRQoL) assessments have identified a detrimental association between aggressive treatment and overall health status, physical functioning, and relationships. In contrast, organ-sparing demonstrates improved measures related to HRQoL and sexual function. Assessment through validated questionnaires reveals diverse voiding outcomes, and varying impacts on QoL and sexual activity, emphasizing the necessity for multidisciplinary personalized care. Studies highlight substantial variations in sexual function, with patients reporting adaptations, reduced satisfaction, and concerns about body image and sexual well-being. Furthermore, unmet needs include challenges in patient–clinician communication, obtaining information, and accessing psychosocial support. Patient experiences underscore the importance of timely diagnosis, treatment access, and addressing psychological consequences. Organ-sparing approaches have higher QoL preservation and sexual function. Individualized support, including sexual therapy, support groups, and family counseling, is essential for post-treatment rehabilitation. Timely diagnosis and comprehensive care are paramount in addressing the multifaceted impact of PC on patients and families. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to create a nomogram for predicting survival outcomes in penile cancer patients, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) and a Chinese organization. Methods: Our study involved a cohort of 5744 patients diagnosed with penile cancer from the SEER database, spanning from 2004 to 2019. In addition, 103 patients with penile cancer from Sun Yat‐sen Memorial Hospital of Sun Yat‐sen University were included during the same period. Based on the results of regression analysis, a nomogram is constructed and validated internally and externally. The predictive performance of the model was evaluated by concordance index (c‐index), area under the curve, decision curve analysis, and calibration curve, in internal and external datasets. Finally, the prediction efficiency is compared with the TNM staging model. Results: A total of 3154 penile patients were randomly divided into the training group and the internal validation group at a ratio of 2:1. Nine independent risk factors were identified, including age, race, marital status, tumor grade, histology, TNM stage, and the surgical approach. Based on these factors, a nomogram was constructed to predict OS. The nomogram demonstrated relatively better consistency, predictive accuracy, and clinical relevance, with a c‐index over 0.73 (in the training cohort, the validation cohort, and externally validation cohort.) These evaluation indexes are far better than the TNM staging system. Conclusion: Penile cancer, often overlooked in research, has lacked detailed investigative focus and guidelines. This study stands as the first to validate penile cancer prognosis using extensive data from the SEER database, supplemented by data from our own institution. Our findings equip surgeons with an essential tool to predict the prognosis of penile cancer better suited than TNM, thereby enhancing clinical decision‐making processes. [ABSTRACT FROM AUTHOR]

Metastasis to the penis from renal cell carcinoma (RCC) or any other primary cancer site is unusual; when it does occur, it often involves multiple organs. A 75-year-old man presented with penile pain and swelling. Three months earlier, he had open radical nephrectomy with thrombectomy and was diagnosed with clear-cell RCC with tumor thrombosis in the inferior vena cava. The follow-up imaging indicated metastasis to the penis, prompting a total penectomy due to worsening pain. The excised mass displayed features consistent with metastatic RCC. This case underscores the need to consider rare metastatic sites, such as the metastasis of RCC to the penis, in RCC patients. [ABSTRACT FROM AUTHOR]

Background: Postoperative lymphatic leakage is a complication of ineffective conservative treatment for retroperitoneal mass. Herein, we report a case of lymphatic leakage that arose after retroperitoneal tumor resection and that was treated with retrograde transvenous thoracic duct embolization. Case presentation: A 28-year-old man with persistent abdominal pain was diagnosed with a large retroperitoneal metastatic tumor measuring 10 cm and a subdiaphragmatic lymph node originating from a testicular tumor. After high orchidectomy and neoadjuvant chemotherapy, the subdiaphragmatic lymph node and retroperitoneal tumor were resected together with the abdominal aorta; the latter was reconstructed using a prosthetic graft. Postoperatively, the patient developed chylothorax. No improvement was observed after conservative treatment that included fasting and somatostatin therapy. The leakage site could not be identified using antegrade lymphangiography of the bilateral inguinal lymph nodes, but was detected using retrograde transvenous lymphangiography. The leakage site was successfully embolized. Conclusion: This case report describes successful treatment with retrograde transvenous thoracic duct embolization for chylothorax following resection of a retroperitoneal tumor and lymph node. This approach is a less invasive and more effective mode of treatment for chylothorax and should be considered before surgical thoracic duct ligation when the leakage point cannot be identified using the antegrade approach. [ABSTRACT FROM AUTHOR]

Objectives: To examine the global disease burden and country‐specific trends of penile cancer incidence by age group and investigate its associations with several factors. Materials and Methods: The Global Cancer Observatory database was interrogated for penile cancer incidence. The 10‐year cancer incidence rates were collected from the Cancer Incidence in Five Continents Plus. The country‐specific data were extracted from the World Health Organization Global Health Observatory and Global Burden of Disease databases for conducting risk factors analysis. The penile cancer incidence was presented using age‐standardised rates. Its associations with various factors were examined by linear regression, while the incidence trend was estimated using joinpoint regression and presented as average annual percentage change with 95% confidence intervals in different age groups. Results: There were an estimated 36 068 new cases of penile cancer in 2020. There was a considerable geographical disparity in the disease burden of penile cancer, with South America reporting the highest incidence. Overall, alcohol drinking, human immunodeficiency virus (HIV) infection, and unsafe sex were positively associated with a higher penile cancer incidence, while circumcision was found to be a protective factor. There has been a mixed trend in penile cancer incidence overall, but an increasing trend was found among younger males. Conclusions: There was a global variation in the penile cancer burden associated with prevalence of alcohol drinking, HIV infection, unsafe sex, and circumcision. The increasing penile cancer incidence in the younger population is worrying and calls for early detection and preventive interventions. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to examine the impact of the COVID-19 pandemic on the structure of patients who had undergone operative treatment for oncological indications at the Urology Clinic of the University Clinical Center Niš in the period from March 2018 to June 2022. The following operations were included: nephrectomy for kidney cancer, nephroureterectomy for upper urothelial cancer, prostatectomy for prostate cancer, cystectomy for bladder cancer, orchiectomy for testicular cancer and penectomy for penile cancer. Data were taken on the number of operations, patients' age and gender and postoperative histopathological findings. Depending on the time the surgery was performed, patients were divided into two groups: the preCOVID group - procedures carried out before the start of the pandemic (March 1, 2018 − March 1, 2020) and the COVID group - procedures carried out after the start of the pandemic (June 2020 − June 2022). A total of 569 investigated operations were performed, 320 before and 249 after the beginning of the pandemic. Nephrectomies were the most frequently performed procedures in both study groups. During the pandemic, a significant decrease in number of prostatectomies and nephrectomies was registered. The proportion of prostatectomies was significantly lower in the COVID group, while the proportion of cystectomies significantly increased. The frequency of stage T4 bladder cancer was significantly higher during the pandemic, while the frequency of stage T3a was significantly lower. When we consider the results of tumor stages after all operative procedures in our study, significantly more patients with T4 stage were registered during the pandemic, the majority with bladder cancer. [ABSTRACT FROM AUTHOR]

Purpose: To assess whether 5‐year overall survival (OS) of squamous cell carcinoma of the penis (SCCP) patients differs from age‐matched male population‐based controls. Methods: We relied on the Surveillance Epidemiology and End Results database (2004–2018) to identify newly diagnosed (2004–2013) SCCP patients. For each case, we simulated an age‐matched control (Monte Carlo simulation), relying on the Social Security Administration (SSA) Life Tables with 5 years of follow‐up. We compared OS between SCCP patients and population‐based controls in a stage‐specific fashion. Smoothed cumulative incidence plots displayed cancer‐specific mortality (CSM) versus other‐cause mortality (OCM). Results: Of 2282 SCCP patients, the stage distribution was as follows: stage I 976 (43%) versus stage II 826 (36%) versus stage III 302 (13%) versus stage IV 178 (8%). At 5 years, OS of SCCP patients versus age‐matched population‐based controls was as follows: stage I 63% versus 80% (Δ = 17%), stage II 50% versus 80% (Δ = 30%), stage III 39% versus 84% (Δ = 45%), stage IV 26% versus 87% (Δ = 61%). At 5 years, CSM versus OCM in SCCP patients according to stage was as follows: stage I 12% versus 24%, stage II 22% versus 28%, stage III 47% versus 14%, and stage IV 60% versus 14%. Conclusion: SCCP patients exhibit worse OS across all stages. The difference in OS at 5 years between SCCP and age‐matched male population‐based controls ranged from 17% to 61%. At 5 years, CSM accounted for 12% to 60% of all deaths, across all stages. [ABSTRACT FROM AUTHOR]

The epidemiology and potential pathogenic roles of human papillomavirus (HPV) and Merkel cell polyomavirus (MCV) in keratinocyte cancers (KCs) arising in people living with HIV (PLWH) compared with HIV-negative individuals are poorly understood. These issues were investigated by a case–control study in which the presence of MCV and HPV DNA was identified by polymerase chain reaction in microdissected formalin-fixed paraffin-embedded tissue from PLWH and HIV-negative individuals. The samples comprised 190 cutaneous and genital KCs/precancers (actinic keratoses, n = 43; cutaneous squamous cell carcinoma (cSCC) in situ , n = 24; basal cell carcinoma, n = 78; cSCC, n = 34; penile carcinoma in situ , n = 9; penile SCC, n = 2 from 104 individuals (PLWH, n = 51; HIV-negative, n = 53). Almost one-quarter of samples were positive for MCV: this was not significantly associated with either HIV status (P = 0.06) nor lesion type. Overall, 36% (16/44) of MCV-positive lesions were coinfected with HPV; this was also not associated with HIV status. These findings indicate that if these viruses do contribute to the pathogenesis of KCs, it is likely to be independent of HIV status. [ABSTRACT FROM AUTHOR]

This case series highlights the importance of a thorough differential diagnosis in patients with groin swelling, often mistaken for inguinal hernias. It presents three patients with groin swelling initially suspected of having inguinal hernias but diagnosed differently upon further investigation. Patient 1 had a recurrence of endometrial adenocarcinoma in the right groin, Patient 2 had penile carcinoma with left inguinal metastasis, and Patient 3 had a metastasis of prostate carcinoma in the left groin. These cases underline the need to consider various pathologies beyond the common diagnosis of inguinal hernia. Accurate diagnosis requires a careful clinical examination and appropriate diagnostic tools, ensuring correct treatment. [ABSTRACT FROM AUTHOR]

Introduction: Extramammary Paget's disease of the scrotum and penis is a relatively rare cutaneous malignant tumor. At present, its pathogenesis, and clinical and pathological characteristics are not very clear. This is controversial regarding surgical margin width to decrease the high recurrence rate. This paper aimed to report the case and review the literature of extramammary Paget's disease of scrotum and penis. Case Presentation: We presented the case of a 74-year-old male patient with the patchy erythema and pruritus in the perineum who was admitted to our department. Biopsy of the large plaque revealed Paget disease. Under the condition of ensuring negative surgical margins by rapid frozen pathology, a wide local excision of the lesion, bilateral orchiectomy, and adnexectomy were performed on the patient. Pathology revealed that many scattered vacuolated Paget cells were observed in the epidermal layer, and the diagnosis was Paget's disease of the scrotum and penis. The 2 cm outside the skin lesion was used as the initial surgical margin, and free skin flap transplantation was used to repair the surgical wound. The patient recovered well and was discharged 1 week after surgery. Conclusion: Currently, histopathologic biopsy is the most important diagnostic method for EMPD. Once confirmed, for patients eligible for surgical intervention, wide local excision of the lesion and rapid intraoperative frozen pathological examination should be performed as soon as possible. The skin flap transplantation is the first choice for the repair of large-scale wound after surgery. [ABSTRACT FROM AUTHOR]

Penile cancer can cause deformity, loss of function, and even death. Therefore, it is essential to identify penile cancer early in the clinical context and to correctly diagnose the patients. Precise staging is critical for penile cancer because the prognosis and management vary depending on lymph node status, the degree of local disease, and other factors. This study was conducted to investigate the epidemiological and clinical characteristics of penile cancer. Methods This was an observational study of carcinoma penis conducted among 15 patients treated in the surgical units of SUT Academy of Medical Sciences Hospital, Vattappara, Trivandrum, from October 2013 to July 2016. A detailed history with respect to primary symptoms such as swelling or ulceration, discharge, bleeding, etc. was obtained. A history of circumcision, sexual hygiene, and habits was obtained. A thorough general, local and regional lymph node examination was carried out. Results The majority of patients (40.00%) were between the ages of 51 and 60, while 26.66% were between the ages of 61 and 70. The oldest patient was 85 years old, and the youngest was 40. Not a single patient was younger than 40 years old, and only two were under 30. Poor personal hygiene, balanitis, and balanoposthitis phimosis were the most frequent predisposing variables. About 40.00% of cases were related to phimosis, 20.00% to balanitis, and 40.00% to poor personal hygiene. The lesion began as an ulceration in 33.33% of patients, as phimosis in 26.66%, and as nodular swelling in 20% of patients. Two patients (13.33%) reported discharge; however, one patient's primary complaint was discomfort or itching. In this study, approximately 20.00% of patients sought medical advice after three months, while 33.33% of patients did so after one to three months. In a month, only two patients made an appearance. Two (13.33%) of the patients showed up two years later. Conclusion Penile cancer is still a common condition in our country, primarily affecting men over the age of 50, with phimosis serving as a significant risk factor. The majority of patients presenting with an ulcer were found to have affected the glans the most frequently. The wait period is between one and three months for medical care. Reducing the incidence of this disease might benefit from more research on the topic that explores the causal causes and preventive approaches. [ABSTRACT FROM AUTHOR]

Surgery remains the standard for lymph-node (LN) metastatic penile cancer. Surveillance or delayed LN dissection (LND) risks missing a curative opportunity. Minimally invasive techniques seem to be feasible and may reduce wound related complications. (Neo)adjuvant treatment has no proven benefit in pN1 disease. More advanced disease is rarely cured by surgery alone and multimodal treatment should be considered after multidisciplinary team discussion. Further prospective and randomised trials on minimally invasive LND, multimodal/novel systemic therapies, and management of recurrent LN are needed. Lymph node (LN) involvement in penile cancer is associated with poor survival. Early diagnosis and management significantly impact survival, with multimodal treatment approaches often considered in advanced disease. To assess the clinical effectiveness of treatment options available for the management of inguinal and pelvic lymphadenopathy in men with penile cancer. EMBASE, MEDLINE, the Cochrane Database of Systematic Reviews, and other databases were searched from 1990 to July 2022. Randomised controlled trials (RCTs), nonrandomised comparative studies (NRCSs), and case series (CSs) were included. We identified 107 studies, involving 9582 patients from two RCTs, 28 NRCSs, and 77 CSs. The quality of evidence is considered poor. Surgery is the mainstay of LN disease management, with early inguinal LN dissection (ILND) associated with better outcomes. Videoendoscopic ILND may offer comparable survival outcomes to open ILND with lower wound-related morbidity. Ipsilateral pelvic LN dissection (PLND) in N2–3 cases improves overall survival in comparison to no pelvic surgery. Neoadjuvant chemotherapy in N2–3 disease showed a pathological complete response rate of 13% and an objective response rate of 51%. Adjuvant radiotherapy may benefit pN2–3 but not pN1 disease. Adjuvant chemoradiotherapy may provide a small survival benefit in N3 disease. Adjuvant radiotherapy and chemotherapy improve outcomes after PLND for pelvic LN metastases. Early LND improves survival in nodal disease in penile cancer. Multimodal treatments may provide additional benefit in pN2–3 cases; however, data are limited. Therefore, individualised management of patients with nodal disease should be discussed in a multidisciplinary team setting. Spread of penile cancer to the lymph nodes is best managed with surgery, which improves survival and has curative potential. Supplementary treatment, including the use of chemotherapy and/or radiotherapy, may further improve survival in advanced disease. Patients with penile cancer with lymph node involvement should be treated by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) and the Korea Disease Control and Prevention Agency updated the guidelines for human papillomavirus (HPV) vaccine against sexually transmitted HPV infections in Korea to respond to changing epidemiologic trends, evolving scientific evidence, and advances in laboratory diagnostics and research. Main purpose and recommendation of vaccination against HPV are as follows: (1) the purpose of HPV vaccine is to reduce the risk of genital warts and HPV-related cancers including cervical and vulvar cancer, head and neck cancer, anal cancer, and penile cancer; (2) in Korea, bivalent (16, 18) vaccines, quadrivalent vaccines (6, 11, 16, 18), and 9-valent vaccines (6, 11, 16, 18, 31, 33, 45, 52, 58) are used depending on the type of HPV; (3) bivalent and quadrivalent vaccines are national immunizations targeting girls aged 11-12 years and low-income young females aged 18-26 years (age and range of inoculation: routinely administered at 11 or 12 years of age, 2 doses at 0 and 6 months for 12-14 years of age; for females aged 15-26 years, 3 doses depending on the type of vaccine; vaccination can be given to those aged up to 45 years through consultation with a clinician); (4) in the case of administering 2 doses, at least 5 months apart; in the case of administering 3 doses, it is recommended to keep 4 weeks between the 1st and 2nd doses, 12 weeks between the 2nd and 3rd doses, and 5 months between the 1st and 3rd doses; (5) immunocompromised patients such as those with HIV, malignant neoplasms, and autoimmune diseases, and those undergoing transplantation or immunosuppressive therapy should receive 3 doses. HPV vaccine is not recommended during pregnancy. [ABSTRACT FROM AUTHOR]

Sexuality in cancer patients is a complex area. It is estimated that 81% of patients with urological cancer develop problems in their sexual functionality, even from the moment of diagnosis and aggravated during treatment due to direct injury to the genitalia. Currently, there are few avenues of care within the field of urology that address sexual health and quality of sexual life in penile cancer survivors, which causes many of them to lose self‐esteem and have problems with their partners. To review the literature on what are the consequences on the sexual life of penile cancer survivors in terms of their performance, including risk factors associated with penile cancer and what are the alternatives they must recover their sexual life. Most penile cancer survivors develop alterations in sexual performance and functionality, such as loss of sexual interest, dysfunctional ejaculation, and loss of orgasm, increasing the risk of depression and anxiety. Sex therapy is presented as an alternative to improve the quality of life of these patients, proposing sexuality as something more than genitalia and helping to lead a better life. Sex therapy is an alternative and should be contemplated in the therapeutic plan of patients with urological cancer, especially penile cancer, since sexuality is part of an individual's life, and its loss affects the quality of life. [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate the role of preoperative albumin-to-alkaline phosphatase ratio (AAPR) in predicting pathologic node-positive (pN+) disease in penile cancer (PC) patients undergoing inguinal lymph node dissection (ILND). Materials and Methods: Clinical data of patients with squamous cell carcinoma (SCC) PC + ILND at a single high-volume institution between 2016 and 2021 were collected and retrospectively analyzed. An AAPR was obtained from preoperative blood analyses performed within 30 days from their scheduled surgery. A ROC curve analysis was used to assess AAPR cutoff, in addition to the Youden Index. Logistic regression analysis was utilized for an odds ratio (OR), 95% confidence interval (CI) calculations, and an estimate of pN+ disease. A p value < 0.05 was considered to be as statistically significant. Results: Overall, 42 PC patients were included in the study, with a mean age of 63.6 ± 12.9 years. The AAPR cut-off point value was determined to be 0.53. The ROC curve analysis reported an AUC of 0.698. On multivariable logistic regression analysis lymphovascular invasion (OR = 5.38; 95% CI: 1.47–9.93, p = 0.022), clinical node-positive disease (OR = 13.68; 95% CI: 4.37–43.90, p < 0.009), and albumin-to-alkaline phosphatase ratio ≤ 0.53 (OR = 3.61; 95% CI: 1.23–12.71, p = 0.032) were predictors of pN+ involvement. Conclusions: Preoperative AAPR may be a potentially valuable prognostic marker of pN+ disease in patients who underwent surgery for PC. [ABSTRACT FROM AUTHOR]

High-risk human papillomavirus (HR-HPV) is associated with the development of different types of cancer, such as cervical, head and neck (including oral, laryngeal, and oropharyngeal), vulvar, vaginal, penile, and anal cancers. The progression of premalignant lesions to cancer depends on factors associated with the host cell and the different epithelia infected by HPV, such as basal cells of the flat epithelium and the cells of the squamocolumnar transformation zone (STZ) found in the uterine cervix and the anal canal, which is rich in heparan sulfate proteoglycans and integrin-like receptors. On the other hand, factors associated with the viral genotype, infection with multiple viruses, viral load, viral persistence, and type of integration determine the viral breakage pattern and the sites at which the virus integrates into the host cell genome (introns, exons, intergenic regions), inducing the loss of function of tumor suppressor genes and increasing oncogene expression. This review describes the role of viral integration and the molecular mechanisms induced by HR-HPV in different types of tissues. The purpose of this review is to identify the common factors associated with the role of integration events in the progression of premalignant lesions in different types of cancer.

Abstract Background Lymphatic metastasis is the major challenge in the treatment of penile cancer. The prognosis of individuals with lymphatic metastasis is extremely poor. Therefore, early identification of disease progression and lymphatic metastasis is an urgent task for researchers in penile cancer worldwide. Methods In this study, using single‐cell RNA sequencing, an immune landscape was established for the cancer ecosystem based on 46,861 cells from six patients with penile cancer (four with lymphatic metastasis [stage IV] and two without lymphatic metastasis [stage I]). Using bulk RNA sequencing, the discrepancy between the cancers and their respective metastatic lymph nodes was depicted based on seven patients with penile cancer. Results The interaction between epithelial cells, fibroblasts, and endothelial cells, and the functional cooperation among invasion, epithelial‐mesenchymal transition, and angiogenesis were found to be important landscapes in the penile cancer ecosystem, playing important roles in progression of cancer and lymph node metastasis. Conclusions This study is the first to investigate the altered tumor microenvironment heterogeneity of penile cancer as it evolves from non‐lymphatic to lymphatic metastasis and provides insights into the mechanisms underlying malignant progression, the premetastatic niche, and lymphatic metastasis in penile cancer.

Abstract Introduction Penile cancer (PC) is a lethal malignancy with no effective prognostic biomarker. We aim to investigate associations between trajectories of squamous cell carcinoma antigen (SCC‐A) and patient outcomes after chemotherapy based on paclitaxel, ifosfamid, and cisplatin (TIP) regimen. Methods Consecutive AJCC staging III/IV PC patients who received TIP chemotherapy and repeated SCC‐A measurements in 2014–2022 were analyzed. Latent class growth mixed (LCGM) models were employed to characterize patients' serum SCC‐A trajectories. Patient survival, and clinical and pathological tumor responses were compared. Inverse probability treatment weighting was used to adjust confounding factors. Results Eighty patients were included. LCGM models identified two distinct trajectories of SCC‐A: low‐stable (40%; n = 32) and high‐decline (60%; n = 48). Overall survival (HR [95% CI]: 3.60 [1.23–10.53], p = 0.019), progression‐free survival (HR [95% CI]: 11.33 [3.19–40.3], p

Abstract Background Penile squamous cell carcinoma (PSCC) is a highly aggressive malignancy with a poor prognosis. BRCA1/2 mutations are associated with impaired DNA double-strand break repair and are among the common mutations in penile cancer, potentially paving the way for poly ADP-ribose polymerase inhibitor therapy. Case presentation We report a 65-year-old male with PSCC who progressed to thigh metastasis at 10 months after partial penectomy. Next-generation sequencing showed that the penis primary lesion and metastatic thigh lesion harboured a BRCA2 mutation. Chemotherapy plus immunotherapy was used for treatment, and the thigh metastasis was found to involve no tumour. Progression-free survival (PFS) lasted for 8 months until the appearance of lung metastasis. Afterwards, the patient benefited from second-line therapy of olaparib with pembrolizumab and anlotinib, and his disease was stable for 9 months. The same BRCA2 was identified in the lung biopsy. Given the tumour mutation burden (TMB, 13.97 mutation/Mb), the patient received third-line therapy with nivolumab plus ipilimumab, but PFS only lasted for 3 months, with the appearance of right frontal brain metastasis. Then, the patient was treated with radiation sequential fluzoparib therapy as fourth-line treatment, and the treatment efficacy was evaluated as PR. Currently, this patient is still alive. Conclusions This is the first report of penile cancer with BRCA2 mutation, receiving a combination treatment with olaparib and experiencing a benefit for 9 months. This case underscores the pivotal role of BRCA2 in influencing treatment response in PSCC, providing valuable insights into the application of targeted therapies in managing recurrent PSCC with BRCA2 alterations. This elucidation establishes a crucial foundation for further research and clinical considerations in similar cases.

This article discusses a recent publication that focused on patients with penile cancer (PeCa) using the Surveillance, Epidemiology, and End Results (SEER) database. The authors aimed to identify predictors for overall mortality (OM) and constructed a nomogram based on factors such as TNM stage, age, race, marital status, histological subtype, tumor grade, and surgical intervention. The nomogram showed good calibration and predictive qualities. However, there are some concerns about missing information, validity of certain factors, and the reliability of the nomogram. The article also mentions a bibliometric analysis of survival analyses of PeCa patients based on the SEER database, questioning the necessity of more studies using this data. The authors suggest the need for nomograms based on specific histopathological criteria and the integration of meaningful biomarkers to improve long-term prognosis for PeCa patients. [Extracted from the article]

The article discusses the use of organ-sparing surgery for genitourinary cancers, such as bladder and renal cancer. It explains that traditional radical surgeries are being replaced by organ-sparing surgeries due to improved prognosis and quality of life. The article highlights specific examples of bladder-preserving therapies and nephron-sparing surgery for renal tumors. It emphasizes the need for further research to establish standard treatment protocols. [Extracted from the article]

This document is a summary of a special issue titled "Clinical Trends and Novel Research Insights into Testicular and Penile Disorders and Infertility." The issue includes a collection of studies and reviews that aim to enhance understanding and drive innovations in the field of urology. The topics covered in the special issue range from surgical reconstructions of congenital genital anomalies to exploring potential causes of decline in global fertility and investigating associations between asthma and male infertility. The studies provide valuable contributions to the understanding of testicular and penile disorders and infertility. [Extracted from the article]

Background: Men with localized invasive penile cancer (PC) can be treated with organ-sparing treatments with different functional and aesthetical outcomes. Thus, the aim of this study is to investigate sexual outcomes in patients with PC confined to the glans that underwent wide local excision (WLE) vs. glansectomy with urethral glanduloplasty. Methods: Complete data from 60 patients with PC were analyzed at our institution from 2017 to 2022. Patients were asked for personal habits and clinical features. PC was assessed with a clinical visit and imaging techniques. At the outpatient follow-up visit or phone call, all patients compiled the Changes in Sexual Function Questionnaire (CSFQ) and the International Index of Erectile Function in its short 5-item form (IIEF-5). Erectile function (EF) impairment was categorized using Cappelleri’s criteria. Results: Overall, 34 patients with PC confined to the glans (c ≤ T2N0) were included. Of those, 12 underwent WLE and 22 underwent glansectomy with urethral glanduloplasty. Using multivariable logistic regression, glansectomy (OR: 3.49) and diabetes (OR: 2.33) were associated with erectile disfunction (IEEF < 22). Meanwhile, using multivariable linear regression analysis, younger patients (Coeff: −2.41) and those that underwent glansectomy (Coeff: −7.5) had a higher risk of sexual function impairment, according to the CSFQ. Conclusions: Patients with PC ≤ T2N0 that underwent WLE have better outcomes in terms of sexual functioning than the patients who underwent glansectomy and uretheral gladuloplasty. Further research is needed to clarify the outcomes of penile-sparing surgery, to inform patients in pre-surgical counseling more comprehensively, and to meet their post-operative expectations more effectively.

Given the rising incidence of human papillomavirus (HPV)-related diseases, including cervical, penile, and oropharyngeal cancers, particularly among men, the implementation of comprehensive HPV vaccination strategies is necessary in South Korea. This position statement advocates the introduction of gender-neutral vaccination (GNV) in the country. It recommends the administration of the HPV vaccine to both men and women aged 9–26 years to prevent a broad spectrum of HPV-related conditions. Specifically, individuals aged 9–14 years are advised to receive two doses of the vaccine, whereas those aged 15–26 years are advised to receive three doses. The optimal age for vaccination is identified as 11–12 years old. Additionally, this statement recommends that women aged 27 years and older be vaccinated based on the discretion of healthcare providers. The introduction of GNV is essential to curb the spread of HPV and reduce the overall burden of HPV-related cancers, making it a critical public health initiative in Korea.