Outcome of penile cancer in circumcised men

Raouf M. Seyam, Nabil K. Bissada, Alaa A. Mokhtar, Walid A. Mourad, Muhammad Aslam, Naser Elkum, Said A. Kattan, Kamal A. Hanash

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

Purpose: We previously reported on a group of patients with post-circumcision carcinoma of the penis. We now study the long-term outcome of these patients. Materials and Methods: We retrospectively reviewed the available charts of 22 patients presenting between October 1979 and May 2000. Results: Of 22 patients 18 underwent ritual circumcision with extensive scar development. Median age at diagnosis was 62.4 years. The penile lesion was dorsal and proximally located in 15 patients. Median delay before diagnosis was 12 months. Clinically 14 patients had stage T1-T2 disease, with 13 having no lymph node involvement and none with distant metastasis, 8 patients had stage T3-T4 disease. A total of 15 patients were treated surgically with total penectomy (10) or conservative local excision (5), inguinal lymph node dissection (9) and subsequent penile reconstruction (3). Pathological staging in 15 patients revealed 10 patients with stage T1 and in 8 patients with lymph node dissection none had nodal metastasis. Histopathological classification was 20 squamous cell carcinoma, 1 sarcoma and 1 verrucous carcinoma. Six patients refused surgery and 1 was referred for palliation. Median followup was 14.5 months and median survival was 14.5 months. The 3-year survival was 42% for stage T1-T2 and 13% for T3-T4 (p = 0.0052). Median survival for the surgical group was 34 months whereas for nonsurgical group was 3 months (p = 0.0016). Recurrence-free survival in the surgical group was 50%. Conclusions: Penile carcinoma in circumcised men is a distinct disease commonly following nonclassic vigorous circumcision. Delayed diagnosis and deferring surgical treatment are associated with increased mortality.

Original languageEnglish
Pages (from-to)557-561
Number of pages5
JournalJournal of Urology
Volume175
Issue number2
DOIs
Publication statusPublished - Feb 2006
Externally publishedYes

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Penile Neoplasms
Survival
Lymph Node Excision
Verrucous Carcinoma
Neoplasm Metastasis
Carcinoma
Ceremonial Behavior
Groin
Delayed Diagnosis
Penis
Sarcoma
Cicatrix

Keywords

  • Carcinoma
  • Circumcision
  • Penis

ASJC Scopus subject areas

  • Urology

Cite this

Seyam, R. M., Bissada, N. K., Mokhtar, A. A., Mourad, W. A., Aslam, M., Elkum, N., ... Hanash, K. A. (2006). Outcome of penile cancer in circumcised men. Journal of Urology, 175(2), 557-561. https://doi.org/10.1016/S0022-5347(05)00234-X

Outcome of penile cancer in circumcised men. / Seyam, Raouf M.; Bissada, Nabil K.; Mokhtar, Alaa A.; Mourad, Walid A.; Aslam, Muhammad; Elkum, Naser; Kattan, Said A.; Hanash, Kamal A.

In: Journal of Urology, Vol. 175, No. 2, 02.2006, p. 557-561.

Research output: Contribution to journalReview article

Seyam, RM, Bissada, NK, Mokhtar, AA, Mourad, WA, Aslam, M, Elkum, N, Kattan, SA & Hanash, KA 2006, 'Outcome of penile cancer in circumcised men', Journal of Urology, vol. 175, no. 2, pp. 557-561. https://doi.org/10.1016/S0022-5347(05)00234-X
Seyam RM, Bissada NK, Mokhtar AA, Mourad WA, Aslam M, Elkum N et al. Outcome of penile cancer in circumcised men. Journal of Urology. 2006 Feb;175(2):557-561. https://doi.org/10.1016/S0022-5347(05)00234-X
Seyam, Raouf M. ; Bissada, Nabil K. ; Mokhtar, Alaa A. ; Mourad, Walid A. ; Aslam, Muhammad ; Elkum, Naser ; Kattan, Said A. ; Hanash, Kamal A. / Outcome of penile cancer in circumcised men. In: Journal of Urology. 2006 ; Vol. 175, No. 2. pp. 557-561.
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abstract = "Purpose: We previously reported on a group of patients with post-circumcision carcinoma of the penis. We now study the long-term outcome of these patients. Materials and Methods: We retrospectively reviewed the available charts of 22 patients presenting between October 1979 and May 2000. Results: Of 22 patients 18 underwent ritual circumcision with extensive scar development. Median age at diagnosis was 62.4 years. The penile lesion was dorsal and proximally located in 15 patients. Median delay before diagnosis was 12 months. Clinically 14 patients had stage T1-T2 disease, with 13 having no lymph node involvement and none with distant metastasis, 8 patients had stage T3-T4 disease. A total of 15 patients were treated surgically with total penectomy (10) or conservative local excision (5), inguinal lymph node dissection (9) and subsequent penile reconstruction (3). Pathological staging in 15 patients revealed 10 patients with stage T1 and in 8 patients with lymph node dissection none had nodal metastasis. Histopathological classification was 20 squamous cell carcinoma, 1 sarcoma and 1 verrucous carcinoma. Six patients refused surgery and 1 was referred for palliation. Median followup was 14.5 months and median survival was 14.5 months. The 3-year survival was 42{\%} for stage T1-T2 and 13{\%} for T3-T4 (p = 0.0052). Median survival for the surgical group was 34 months whereas for nonsurgical group was 3 months (p = 0.0016). Recurrence-free survival in the surgical group was 50{\%}. Conclusions: Penile carcinoma in circumcised men is a distinct disease commonly following nonclassic vigorous circumcision. Delayed diagnosis and deferring surgical treatment are associated with increased mortality.",
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AU - Seyam, Raouf M.

AU - Bissada, Nabil K.

AU - Mokhtar, Alaa A.

AU - Mourad, Walid A.

AU - Aslam, Muhammad

AU - Elkum, Naser

AU - Kattan, Said A.

AU - Hanash, Kamal A.

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N2 - Purpose: We previously reported on a group of patients with post-circumcision carcinoma of the penis. We now study the long-term outcome of these patients. Materials and Methods: We retrospectively reviewed the available charts of 22 patients presenting between October 1979 and May 2000. Results: Of 22 patients 18 underwent ritual circumcision with extensive scar development. Median age at diagnosis was 62.4 years. The penile lesion was dorsal and proximally located in 15 patients. Median delay before diagnosis was 12 months. Clinically 14 patients had stage T1-T2 disease, with 13 having no lymph node involvement and none with distant metastasis, 8 patients had stage T3-T4 disease. A total of 15 patients were treated surgically with total penectomy (10) or conservative local excision (5), inguinal lymph node dissection (9) and subsequent penile reconstruction (3). Pathological staging in 15 patients revealed 10 patients with stage T1 and in 8 patients with lymph node dissection none had nodal metastasis. Histopathological classification was 20 squamous cell carcinoma, 1 sarcoma and 1 verrucous carcinoma. Six patients refused surgery and 1 was referred for palliation. Median followup was 14.5 months and median survival was 14.5 months. The 3-year survival was 42% for stage T1-T2 and 13% for T3-T4 (p = 0.0052). Median survival for the surgical group was 34 months whereas for nonsurgical group was 3 months (p = 0.0016). Recurrence-free survival in the surgical group was 50%. Conclusions: Penile carcinoma in circumcised men is a distinct disease commonly following nonclassic vigorous circumcision. Delayed diagnosis and deferring surgical treatment are associated with increased mortality.

AB - Purpose: We previously reported on a group of patients with post-circumcision carcinoma of the penis. We now study the long-term outcome of these patients. Materials and Methods: We retrospectively reviewed the available charts of 22 patients presenting between October 1979 and May 2000. Results: Of 22 patients 18 underwent ritual circumcision with extensive scar development. Median age at diagnosis was 62.4 years. The penile lesion was dorsal and proximally located in 15 patients. Median delay before diagnosis was 12 months. Clinically 14 patients had stage T1-T2 disease, with 13 having no lymph node involvement and none with distant metastasis, 8 patients had stage T3-T4 disease. A total of 15 patients were treated surgically with total penectomy (10) or conservative local excision (5), inguinal lymph node dissection (9) and subsequent penile reconstruction (3). Pathological staging in 15 patients revealed 10 patients with stage T1 and in 8 patients with lymph node dissection none had nodal metastasis. Histopathological classification was 20 squamous cell carcinoma, 1 sarcoma and 1 verrucous carcinoma. Six patients refused surgery and 1 was referred for palliation. Median followup was 14.5 months and median survival was 14.5 months. The 3-year survival was 42% for stage T1-T2 and 13% for T3-T4 (p = 0.0052). Median survival for the surgical group was 34 months whereas for nonsurgical group was 3 months (p = 0.0016). Recurrence-free survival in the surgical group was 50%. Conclusions: Penile carcinoma in circumcised men is a distinct disease commonly following nonclassic vigorous circumcision. Delayed diagnosis and deferring surgical treatment are associated with increased mortality.

KW - Carcinoma

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