Evaluating the role of adjuvant therapy in improving outcomes for patients with lymph node-positive penile cancer following surgical management
- Radion Garaz 1, Cristian Mirvald 2, Cristian Surcel 2, Asif Muneer 3, Anita Thomas 4, Steffen Rausch 1, Maximilian Niyazi 5, Hathal Haddad 5, Elgin Hoffmann 5, Olesya Vakhrusheva 1, Igor Tsaur 1
- 1Department of Urology, University Hospital Tübingen, Tübingen, Germany.
- 2Department of Urology, Fundeni Clinical Institute, Bucharest, Romania; 'Carol Davila' Bucharest, University of Medicine and Pharmacy, Bucharest, Romania.
- 3Department of Urology, Male Genital Cancer Center, University College London Hospitals NHS Foundation Trust, London, UK; NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
- 4Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany.
- 5Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.
- 0Department of Urology, University Hospital Tübingen, Tübingen, Germany.
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View abstract on PubMed
Summary
This summary is machine-generated.Adjuvant therapy improves outcomes for penile squamous cell carcinoma (PeCa) with positive lymph nodes (pN+). Individualized strategies considering risk factors and biomarkers are crucial for optimizing survival and reducing recurrence.
Area Of Science
- Oncology
- Surgical Oncology
- Radiation Oncology
Background
- Penile squamous cell carcinoma (PeCa) presents poor prognosis in node-positive (pN+) cases, especially with extranodal extension (ENE) or pelvic lymph node (PLN) involvement.
- The optimal role and strategies for adjuvant therapy (AT) after radical lymphadenectomy (LAD) for pN+ PeCa remain undefined.
Purpose Of The Study
- To review the impact of AT on survival and recurrence in pN+ PeCa.
- To assess AT-associated toxicities and explore personalized treatment approaches.
- To identify emerging biomarkers and novel therapeutic strategies for pN+ PeCa.
Main Methods
- Systematic literature search of PubMed, Web of Science, Cochrane Library, and Scopus (January 2000 - December 2024).
- Inclusion of studies evaluating adjuvant radiotherapy (ART), chemotherapy (ACT), chemoradiotherapy (ACRT), targeted therapies, or combination regimens after LAD for pN+ PeCa.
- Evaluation of survival outcomes, recurrence rates, and treatment toxicities.
Main Results
- ART improves locoregional control in patients with ≥ 2 positive inguinal lymph nodes, particularly in HPV+ tumors.
- ACT (TIP or TPF regimens) enhances disease-free and overall survival in high-risk pN+ patients, including those with PLN involvement.
- ACRT offers modest benefits in ENE cases but carries significant toxicity; HPV status and p53 mutations show potential as predictive biomarkers.
Conclusions
- Adjuvant therapy significantly improves outcomes in pN+ PeCa but necessitates individualized strategies based on risk factors and molecular profiles.
- Prospective, collaborative studies are essential to refine AT protocols, minimize toxicities, and integrate novel agents and biomarkers.
- Multidisciplinary management and centralized care are critical for optimizing outcomes in penile cancer.
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