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- Detection of lymph node metastases in penile cancer - Bloom - Translational Andrology and Urology
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Linear regression was performed when studying the stratification of tumor grade in comparison with tobacco use and nonsmoking patients. Of the patients evaluated, The distribution of patients in relation to the birthplace is shown in Figure Four 1. Of the four foreign patients evaluated one came from Israel and other three from Portugal.
In this series, The level of education ranged from illiterate, with 35 Of the remaining patients, The predominant religion was Catholic, with Only one patient 0. In this series Among circumcised patients, 1 2. Of the circumcised patients, 25 Of the patients evaluated, 31 In relation to pathological variables studied, all patients present squamous cell carcinoma of the penis.
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The lesion size ranged from 0. The initial location of the lesions is shown in Table The clinical and pathological TNM classification is shown in Table Of these patients, 95 Lymphovascular embolization was observed in 63 patients Only 3 patients had lung metastases at diagnosis. The treatment for the patients varied according to the presentation of the primary tumor.
Six 2. Partial penile amputation was performed in Only 10 4. Of the patients evaluated in this series, Of these, 56 After a mean follow-up of Cancer of the penis is a rare neoplasm with low overall incidence. In the United States, it accounts for approximately 0. In Brazil, despite the high incidence in some regions, this disease accounts for about 2.
The incidence of penile cancer varies according to the study area, with its highest incidence reported in the Northeast, representing approximately 5. In our study we found that A recent study by Favorito et al.
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Despite the large migration to the Southeast, because it is the most developed economic region in the country, in this study the incidence of the disease was more prevalent in patients born in the state of Rio de Janeiro. These data suggest that many patients with penile cancer receive specific treatment at their home states, with a decline in the interstate migration.
When the cancer of penis is present, it is prevalent in elderly men, with an abrupt increase in incidence during the sixth decade of life and a new peak around 80 years of age 9. In our series, we observed only 1. The practice of neonatal circumcision seems to be a protective factor in the genesis of cancer of the penis The incidence of penile cancer in the Jewish population, where the practice of neonatal circumcision is universal, is close to zero.
In Muslim countries, where circumcision is performed in childhood beyond the neonatal period, the incidence is up to three times higher In our study, the patients were predominantly Catholic, representing Brazil is the largest Catholic country in South America, explaining the high incidence of disease in this religious group. There are only nine reports of penile cancer in circumcised Jews in the neonatal period reported in the literature Interestingly, we had the opportunity to treat an Israeli Jewish patient, who had undergone neonatal circumcision, with an advanced-stage tumor Figure Several studies have shown an association between penile cancer and smoking.
Hellberg et al. Harish and Ravi extended these observations by demonstrating that the consumption of products made from tobacco is also related to the incidence of penile cancer independent of other factors In our series, we observed a predominance of smokers, representing In assessing the degree of tumor differentiation between smokers and nonsmokers, we found no statistical difference between the 2 groups Table-4 and Figure This study, despite not having used a control group, showed that more than half of the patients with tumor of the penis were smokers, suggesting that smoking may represent a risk factor for the development of penile cancer.
However, the degree of tumor differentiation may not be related to smoking in this series. An interesting finding in this work concerns the marital status of patients: Since it was not possible to determine any relationship between single marital status and sexual behavior, we were unable to identify any predisposing factor for the genesis of penile cancer related to marital status.
Detection of lymph node metastases in penile cancer
It would be reasonable to imagine a lower incidence of penile cancer in patients who were married that theoretically would have a single sexual partner. It is possible that this finding is coincidental and that the only factor associated with this observation is the low economic level of patients and inadequate hygiene conditions, which did not differ between married and single patients. The incidence ranged from 0.
Although some series have shown no racial predisposition 14 , Muir and Nectoux 15 observed a preponderance of in black men. In Brazil, due to the great racial miscegenation is hard to separate the patients by ethnicity since one cannot accurately differentiate blacks, browns and whites. Some authors suggest a higher likelihood of African-Americans to develop more aggressive forms of the disease than white patients In our series, only 20 patients 8.
Thus, we did not observe more aggressive disease in black patients compared to whites.
Detection of lymph node metastases in penile cancer - Bloom - Translational Andrology and Urology
The mechanism of tumor induction and promotion related to human papilloma virus HPV infection is not completely understood. Using koilocytosis to detect the presence of HPV in tumor tissue, we found positive readings in patients Sexually transmitted diseases like herpes, urethritis and syphilis have been implicated as a possible risk factor for the development of penile cancer, however no convincing evidence was found linking them to this disease 5, In our series A possible explanation of the association between penile cancer and STDs is the fact that the patients with STDs have a higher number of sexual partners, increasing the likelihood of HPV infection.
It has been proposed that inadequate hygiene of the preputial sac with consequent accumulation of smegma leads to a chronic local inflammatory process, contributing to the genesis of penile cancer.
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In our study we found 68 patients Of these patients, 45 There are few studies in the literature that correlate the degree of tumor differentiation in the presence or absence of prior circumcision. Get ready for Prime Day with the Amazon App. No purchase necessary. Get started. No customer reviews. Share your thoughts with other customers. Write a customer review.
Research in Functional Urology
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Buy eBook. Rent the eBook. FAQ Policy. Show all. As such, it successfully highlights all of the pertinent clinical points and also reviews some of the recent advances and new directions in the treatment of this uncommon condition. The compilation is geared to a wide audience, including researchers, clinicians, and trainees students and residents.