Features of the clinical course of penile cancer

Introduction. Penile cancer (PC) is one of the rare tumors, accounting for 1-2% of all neoplasms of the genitourinary system. The clinical course of the cancer process raises many questions among both urologistsoncologists in hospitals and outpatient doctors. A retrospective analysis of articles indicates that this process has not been sufficiently studied and requires more clinical observations to determine the diagnosis and correct treatment tactics for such patients.

Materials and methods. Clinical observations of the development of human cancer in patients are presented. An analysis of original articles was also carried out in the following databases: Pubmed, Scopus, Scopus, Web of Science from 2007 to 2022, dedicated to this disease.

Results. When a tumor of the penis was detected, one patient underwent surgical intervention to the extent of amputation of the glans penis. In the second patient, total damage to the penis was revealed, which required more radical surgical treatment including: Emasculation with urethroplasty. The third patient underwent radiation therapy and subsequently circumcision of the foreskin. The postoperative period in patients was without complications. No relapse was observed.

Conclusion.Penile cancer, despite its rarity, is a pressing problem in modern oncology. Even with proper examination and treatment, it is difficult to predict the further development of the disease. These clinical cases force specialists to examine patients more carefully so as not to miss pathology that can cripple the patient and change his future lifestyle, and also shows different options for treatment outcomes for penile cancer.

1. Backes, D.M., et al. Systematic review of human papillomavirus prevalence in invasive penile cancer. Cancer Causes Control, 2009. 20: 449. https://www.ncbi.nlm.nih.gov/pubmed/19082746

2. Chaux, A., et al. Epidemiologic profile, sexual history, pathologic features, and human papillomavirus status of 103 patients with penile carcinoma. World J Urol, 2013. 31: 861. https://www.ncbi.nlm.nih.gov/pubmed/22116602

3. Barnholtz-Sloan, J.S., et al. Incidence trends in primary malignant penile cancer. Urol Oncol, 2007. 25: 361. https://www.ncbi.nlm.nih.gov/pubmed/17826651

4. https://oncology-association.ru/wpcontent/uploads/2022/11/zlokachestvennye-novoobrazovaniya-vrossii-v-2021-g_zabolevaemost-i-smertnost.pdf

5. Thomas, A., Necchi, A., Muneer, A., Tobias-Machado, M., Tran, A. T. H., Van Rompuy, A.-S., … Albersen, M. (2021). Penile cancer. Nature Reviews Disease Primers, 7(1). doi:10.1038/s41572-021-00246-5

6. 1.Douglawi, A. & Masterson, T. A. Penile cancer epidemiology and risk factors: a contemporary review. Curr. Opin. Urol. 29, 145–149 (2019).

7. Olesen, T. B. et al. Prevalence of human papillomavirus DNA and p16(INK4a) in penile cancer and penile intraepithelial neoplasia: a systematic review and meta-analysis. Lancet Oncol. 20, 145–158 (2019).

8. Dräger, D. L., Milerski, S., Sievert, K. D. & Hakenberg, O. W. Psychosocial effects in patients with penile cancer: a systematic review. Urologe A 57, 444–452 (2018).

9. Novara, G., Galfano, A., De Marco, V., Artibani, W. & Ficarra, V. Prognostic factors in squamous cell carcinoma of the penis. Nat. Clin. Pract. Urol. 4, 140–146 (2007).

10. Leijte, J.A., et al. Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a twocentre analysis of 700 patients. Eur Urol, 2008. 54: 161. https://www.ncbi.nlm.nih.gov/pubmed/18440124

11. Rekomendatsii-EAU-2023.

12. Hu X., Huang J., Wen S. et al. Comparison of efficacy between brachytherapy and penectomy in patients with penile cancer: a meta-analysis. Oncotarget. 2017;8(59):100469-100477.

13. Azrif M., Logue J.P., Swindell R. et al. External-beam radiotherapy in T1-2 N0 penile carcinoma. Clinical Oncology (The Royal College of Radiologists). 2006;18(4):320-5.

14. Ornellas, A. A. & Ornellas, P. Should routine neonatal circumcision be a police to prevent penile cancer? Opinion: Yes. Int. Braz. J. Urol. 43, 7–9 (2017). 31. Minhas, S., Manseck, A., Watya, S. & Hegarty, P. K. Penile cancer — prevention and premalignant conditions. Urology 76, S24–S35 (2010).

15. Larke, N. L., Thomas, S. L., dos Santos Silva, I. & Weiss, H. A. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control 22, 1097–1110 (2011).

16. Hernandez, B. Y. et al. Burden of invasive squamous cell carcinoma of the penis in the United States, 1998–2003. Cancer 113, 2883–2891 (2008).

17. Barnholtz-Sloan, J. S., Maldonado, J. L., Pow-sang, J. & Giuliano, A. R. Incidence trends in primary malignant penile cancer. Urol. Oncol. 25, 361–367 (2007)

18. Khansari, N., Shakiba, Y. & Mahmoudi, M. Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer. Recent Pat. Inflamm. Allergy Drug Discov. 3, 73–80 (2009).

19. Reuter, S., Gupta, S. C., Chaturvedi, M. M. & Aggarwal, B. B. Oxidative stress, inflammation, and cancer: how are they linked? Free Radic. Biol. Med. 49, 1603–1616 (2010).

20. Elinav, E. et al. Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms. Nat. Rev. Cancer 13, 759–771 (2013).

21. Hoekstra, R. J., Trip, E. J., Ten Kate, F. J., Horenblas, S. & Lock, M. T. Penile intraepithelial neoplasia: nomenclature, incidence and progression to malignancy in the Netherlands. Int. J. Urol. 26, 353–357 (2019).

22. Akogbe, G. O. et al. Race and prevalence of human papillomavirus infection among men residing in Brazil, Mexico and the United States. Int. J. Cancer 131, E282–E291 (2012).

23. Kristiansen, S. et al. Risk factors for penile intraepithelial neoplasia: a population-based register study in Sweden, 2000-2012. Acta Derm. Venereol. 99, 315–320 (2019)

24. Spiess, P. E., Dhillon, J., Baumgarten, A. S., Johnstone, P. A. & Giuliano, A. R. Pathophysiological basis of human papillomavirus in penile cancer: key to prevention and delivery of more effective therapies. CA Cancer J. Clin. 66, 481–495 (2016)