OBJECTIVE
To describe oncological and functional outcomes in patients treated with reconstructive
organ-sparing surgery (OSS) for squamous cell carcinoma of the penis. Plastic reconstructive
OSS of the penis with a split thickness skin graft has been proposed as a treatment
option for penile cancer, with the objective being preservation of physiological voiding
and sexual function without comprising oncological control.
MATERIALS AND METHODS
Multicenter study reporting clinicopathological data of 57 patients with malignant
lesions of the penis treated with OSS and plastic reconstructive surgery with split
thickness skin graft from 2007 to 2019. Health related quality of life (HRQoL) was
assessed with EuroQoL-5D-3L, urinary symptoms with the International Consultation
on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms, and erectile
function with the International Index of erectile function (IIEF)-5.
RESULTS
Fifty-seven patients underwent OSS reconstructive surgery. Twenty underwent glans
resurfacing, 23 partial penectomy, and 14 glansectomy. Median age was 55.1 years (interquartile
range [IQR] 29-90), median follow-up 55.7 months (3-149). At the time of data analysis,
6 patients had died of Squamous Cell Carcinoma (SCC) (12.5%) and 10 (17.8%) had progressed.
Kaplan-Meier estimates showed a 5-year survival rate of 87.5% and a 5-year progression-free
survival of 83%. We assessed HRQoL and functional outcomes in 32 patients. EuroQol
5D-3L showed a mean health status of 82.5%, median Voiding score of the ICIQ-MLTUS
was 4 (IQR 1-15), and median IIEF-5 19 (IQR 10.75-25).
CONCLUSION
OSS of the penis remains a safe and viable option for the treatment of SCC, ensuring
a favorable appearance of the penis, preserving urinary and sexual function, with
good HRQoL and without comprising oncological safety in selected cases.
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Article info
Publication history
Published online: May 05, 2020
Accepted:
March 22,
2020
Received:
February 12,
2020
Footnotes
ORCID ID: https://orcid.org/0000-0003-0363-5485.
Authors Disclosure: Authors have no conflict of interest to report.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Research and ethics committee Pontificia Universidad Javeriana/(IRB number 20190531-812) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Funding Support: Authors have no funding sources to report.
Identification
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© 2020 Elsevier Inc. All rights reserved.
