Testicular, Penile, and Rare GU Malignancies Interviews with Experts at Conferences
Curated by clinicians: educational forums with videos, abstracts and conference information
Videos April 27, 2021
The State-of-the-Evidence in Brief Reviews by Experts
May 17, 2021
Penile cancer (PC) is a rare malignancy with an incidence estimated less than 1/100 000 per year in the Western World
1-3
Historically, demolitive surgical approaches, such as total or partial penile amputation, were the most commonly used. Indeed, demolitive options were deemed to be necessary in order to respect a macroscopic surgical margin of at least 2 cm.
3-4 If the oncological outcomes of these approaches demonstrated to be satisfactory, they significantly affected aesthetic outcomes, as well as sexual and urinary functions.
GSRGT 2020: Evolution of Systemic Therapies and the Landscape of Clinical Trials Enrolling Patients
(UroToday.com) To discuss the evolution of systemic therapies and the landscape of clinical trials among patients with penile cancer, Dr. Philippe Spiess, the co-Course Director of the Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit, invited Dr. Jad Chahoud, his colleague from the Moffitt Cancer Center.
Dr. Chahoud started by highlighting that penile cancer is a rare disease in the US, representing 0.7% of all cancer, with high-risk HPV responsible for ~50% of all penile squamous cell carcinoma. The majority of these patients will present with localized or locally advanced disease whereby platinum-based combination chemotherapy remains the front-line therapy. The InPACT trial is actively enrolling patients to determine the frontline therapy for locally advanced penile cancer, given there have been limited treatment advancements in the last decade. Survival
GSRGT 2020: Aggressive Surgical Approach for Nodal Disease
(UroToday.com) As part of the penile cancer session at the inaugural Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit, Dr. Maarten Albersen from Belgium discussed aggressive surgical approaches for managing patients with nodal disease. Dr. Albersen notes that risk of nodal metastasis is based on the European Association of Urology (EAU) risk delineation:
EAU good risk (pT1G1): 0% risk
EAU intermediate risk (pT1G2): 9% risk
EAU high risk (≥ pT2, G3, or LVI): 23% risk
Indeed, appropriate staging of the inguinal lymph nodes is crucial to management. Dynamic sentinel biopsy is one option but has a high false-negative rate outside of high-volume centers. The National Comprehensive Cancer Network (NCCN) guidelines suggest that 20 procedures performed annually should be the baseline, with a steep learning curve of ~30-50 cases. Comparatively, inguinal lymph node dissection has a low false-negative rat