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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Penile cancer, with an incidence of 0.1-0.9/100,000 males/year, is one of the least common malignant tumors. Most patients are over 50 years old and the tumor is slow growing. Therapeutic success is highly dependent on lymph node status. Cancer related death is usually due to local complications such as arrosion bleeding caused by the tumor or infected inguinal metastases. The therapy for advanced penile cancer and its complications represents a challenge. Taking into consideration quality of life, the therapeutic strategy should be based on the patient's age, his sexual function, motivation and psychological condition, as well as previous illnesses and tumor biology. Palliative therapy requires good interdisciplinary work between oncologists, radiologists, plastic surgeons, physiotherapists and psychologists.
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PMID:[Options in palliative therapy for penile cancer]. 1720 67

Squamous cell carcinoma (SCC) of the penis is an uncommon disease in the US and Europe. Without treatment, patients with penile SCC usually die within 2 years after diagnosis of the primary lesion, because of uncontrollable locoregional disease or from distant metastases. The spread of the tumor to the locoregional lymph nodes (lymph-node positivity) is the most relevant prognostic factor. With the available treatments, 5-year cancer-specific survival probabilities are between 75% and 93% for those patients with clinically node-negative disease, and progressively lower for those with increasingly extensive node-positive disease. Similarly, patients with pathologically proven negative nodes have 5-year cancer-specific survival probabilities ranging from 85% to 100%. While patients with a single positive superficial lymph node on pathology have very good cancer-related outcomes, patients with multiple involved lymph nodes have significantly less favorable outcomes. This article focuses on the most important issues that surround the prognosis of squamous cell carcinoma of the penis, with special attention to the prognostic nomograms for penile cancer patients published in 2006.
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PMID:Prognostic factors in squamous cell carcinoma of the penis. 1734 58

In patients with penile cancer, positron emission tomography (PET) is important for identifying metastatic lesions and for therapeutic strategy planning. By using PET/computerised tomography -CT scanning, more precise localization and attenuation correction is provided by CT as an additional advantage for diagnosis. A 78-year-old man with squamous cell cancer of the glans penis diagnosed after histopathological examination was referred to our Nuclear Medicine Department PET/CT unit by the Urology Department of our Hospital, for investigation of metastases and for therapeutic strategy planning. There was significantly increased focal fluoro-18 fluorodeoxyglucose (18F-FDG) activity (SUV: 18.2) in the glans penile area and slightly increased activity in the right inguinal region which was described as inflammation by the histopathological examination. There was no other increased abnormal 18F-FDG activity. 18F-FDG PET or PET/CT may be used in squamous cell cancer of the penis for the detection of metastases and for therapeutic strategy planning. Finally, invasive procedures such as total bilateral inguinal lymphadenectomy, having a high morbidity, may be avoided.
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PMID:Fluoro-18 fluorodeoxyglucose positron emission tomography/computerized tomography scans in a patient with penile cancer for appropriate therapeutic strategy. 1768 88

Penile cancer is an uncommon malignancy in the Developed World. They are dispersed mainly via the lymphatic pathway. We present a single case of massive intracardiac metastases secondary to epidermoid carcinoma of the penis. This is an extremely rare entity which has scarcely been documented.
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PMID:Massive intracardiac metastases secondary to squamous cell carcinoma located at the level of the penis. 1770 29

With an incidence of 0.1-0.9/100,000 men per year penile cancer is a rare cancer of the urogenital tract in Western Europe. At the time of initial diagnosis up to 45% of the patients already demonstrate metastatic disease and need some type of systemic treatment. It is the aim of this paper to review the current concepts of adjuvant and neoadjuvant chemotherapy for locally advanced penile cancer. A curative effect of combined surgical and cytotoxic management can only be achieved in patients with locoregional spread to the lymph nodes, but not with systemic spread. Although there are prospective randomized trials available indicating the optimal cytotoxic regime, cisplatin-based protocols or combination therapies with bleomycin, vincristine, and methotrexate appear to be the most effective options. Finally, there are no data available with regard to the effect of adjuvant chemotherapy on progression-free survival. In patients with locoregional bulky disease or with fixed inguinal lymph nodes, neoadjuvant chemotherapy will result in a partial response in 20-60% of patients and enables complete resection of the mass. For the future, the use of taxane-based chemotherapy as described for squamous cell cancer of other origin might improve outcome.
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PMID:[Neoadjuvant and adjuvant chemotherapy in patients with advanced penile cancer]. 1784 39

One of the most serious problems of urology as specialized surgery is the oncological diseases. A large part of the scientific research is dedicated to their basic research, diagnostics and treatment as the results are then presented at the big international forums each year. The new achievements in the investigations of urological diseases excite special interest and mark the stages of the actual progress of the respective science. The overview is a panorama of the newest and at the same time most significant achievements of the science of urology in this field in 2006 presented at the biggest international congresses - the Congress of the European Association of Urology, the Annual Meeting of the American urologists and the Congress of the American Society of Clinical Oncology - ASCO. What is typical is the existence of the large number of researches of the carcinoma of the prostate - an issue on which the urological society focuses its attention quite often. Without any revolutionary breakthroughs being made new scientific proof has been added which considerably enriches our knowledge about this disease and places special focus on the real value and interpretation of the levels of the Prostate Specific Antigen (PSA). What is especially impressive in bladder cancer research is the discovery of a protein element called "survivin", which is of the family of the inhibitors of apoptosis and its level is connected with qualities of the tumors like aggressiveness, recurrence and progression of the disease and mortality rate. The weight of the scientific research in the field of kidney tumors is placed on the basic research of their oncogenesis. After quite a few years of standstill in the area of chemotherapy new drugs like Sunitinib, Sorafenib and Temserolimus are being introduced, some of which even have independent antitumor effect. As far as the testicle tumors are concerned, the necessity of an extensive lymphadenectomy is confirmed. The increased possibilities of conservative treatment of the lymph node metastases are stressed though radiation therapy and chemotherapy, especially in the cases of seminoma tumors. In the case of penis cancer the weight is placed on the timely diagnostics and treatment allowing organ-preserving operations. The summarized messages of the achievements that are part of the development of the oncourology have also been pointed out.
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PMID:[Current progress and problems in oncourology]. 1843 12

With an incidence of 0.1-0.9/100,000 men/year, penile cancer is a rare cancer of the urogenital tract in Western Europe. At the time of initial diagnosis up to 45% of the patients already demonstrate metastatic disease and need some type of systemic treatment. Objective remission rates and 3-year survival rates of 30 and < 10%, respectively, are depressingly low. Identification of molecular targets for the introduction of molecular triggered therapies such as monoclonal antibodies and tyrosine kinase inhibitors might improve the poor prognosis and could replace non-targeted systemic chemotherapies with a less toxic targeted therapy.However, a MEDLINE search does not identify any current clinical trial with regard to targeted therapeutic approaches in penile cancer. Based on a systematic review of the molecular events involved in the metastatic process of penile cancer, therapeutic approaches with bevacizumab or COX-2 inhibitors appear to have the greatest potential to improve the prognosis. In order to perform a prospective clinical phase 2/3 trial in such a low frequency cancer, international cooperative structures have to be established.
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PMID:[Value of targeted therapy for penile cancer]. 1858 53

This review illustrates the relevance of computed tomography (CT) and magnetic resonance imaging (MRI) for detecting or excluding lymph node metastases in urological malignancies. Although radiological assessment of lymph node metastases is well established in renal cell and testicular cancer, it is unreliable in prostate, bladder, and penile cancer. MR lymphography has shown promising results in these tumors, but because marketing authorization for the iron oxide contrast agent is lacking, it is not clinically applicable. Percutaneous CT-guided biopsy in the retroperitoneum and pelvis is introduced as an alternative in the histological exploration of suspicious lymph nodes.
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PMID:[Relevance of radiological imaging for lymph node surgery of urological tumors]. 1904 23

Penile cancer is a rare carcinoma and visceral metastases are uncommon. Metastasis diagnosis is carried out with TDM and MRI but markers can sometimes be helpful (ie SSCAg). There is no referent chemotherapy, a trial has been started (CAVER).
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PMID:[Metastases from squamous cell carcinoma of the penis]. 1907 Aug 21

The purpose of this study was to assess the utility of sentinel lymph node lymphoscintigraphy (SLNL) and ultrasound-guided fine needle aspiration cytology (FNAC) in patients with penile carcinoma. A prospective study was undertaken of 64 patients with stage T1 (or greater) clinically N0 squamous cell carcinoma of the penis. Patients underwent SLNL and bilateral groin ultrasonography with or without FNAC. Following intradermal blue dye, patients underwent unilateral or bilateral sentinel lymph node excision biopsy (SNB). 17 patients had sentinel nodes that contained metastases (21 nodal basins). Lymphatic drainage was demonstrated in all patients by lymphoscintigraphy. Bilateral drainage was seen in 57/64 patients. 61/64 patients had ultrasonography of the inguinal basins on the same day as FNAC of 38 basins. FNAC showed malignancy in eight basins. FNAC was negative in six basins, which were subsequently shown to be positive following SNB. 82 inguinal basins did not warrant FNAC by ultrasound criteria, of which 5 contained metastases at SNB. The sensitivity and specificity of ultrasonography was 74% and 77%, respectively. The positive and negative predictive values were 37% and 94%, respectively. Two patients had a negative initial SNB; however, ultrasonography identified a metastatic node and re-evaluation of the sentinel node confirmed micro-metastases. There has been no evidence of recurrence in any patients with negative SNB (during 6-28 months' follow-up). In conclusion, when investigating clinically stage N0 penile cancer, the combination of SNB and groin ultrasonography, with or without FNAC, identifies accurately those with occult nodal metastases. Ultrasonography alone is not adequate as a staging technique, and SNB alone might miss between 5% and 10% of metastases.
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PMID:Sentinel lymph node biopsy using dynamic lymphoscintigraphy combined with ultrasound-guided fine needle aspiration in penile carcinoma. 1909 15


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