CAN SQUAMOUS CELL CARCINOMA OF THE ANTERIOR MALE URETHRA BE MANAGED BY FOLLOWING A PENILE CANCER BEST PRACTICE PATHWAY?

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2018MP37-11 CAN SQUAMOUS CELL CARCINOMA OF THE ANTERIOR MALE URETHRA BE MANAGED BY FOLLOWING A PENILE CANCER BEST PRACTICE PATHWAY? Aditya Manjunath, Hussain AlNajjar, Catherine Corbishley, Benjamin Ayres, and Nick Watkin Aditya ManjunathAditya Manjunath More articles by this author , Hussain AlNajjarHussain AlNajjar More articles by this author , Catherine CorbishleyCatherine Corbishley More articles by this author , Benjamin AyresBenjamin Ayres More articles by this author , and Nick WatkinNick Watkin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1217AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Primary squamous cell carcinoma of the anterior male urethra (SCCmu) is rare and the largest published series to date is only 18 patients. In our experience, we believe that SCCmu behaves in a similar way to primary squamous cell carcinoma of the penis (SCCp). In our tertiary referral centre we have managed patients with SCCmu based on our penile cancer pathway in a multi-disciplinary setting in the absence of alternative clinical evidence. We report a comparative study to test the hypothesis that it is oncologically acceptable to manage SCCmu according to the more established SCCp pathway. METHODS Data was collected prospectively on all patients with SCCmu and SCCp from 2001 to 2016. Cases of urothelial tumour, melanoma of urethral origin and metastases to the penis from other sites were excluded. All patients were discussed at our supra-regional MDT and managed according to network guidelines. Management included penile and urethral preserving surgery where possible and inguinal dynamic sentinel node biopsy for cN0 patients (from 2003). Pathology was reported and reviewed by specialist genito-urethral pathologists according to national guidelines. Comparative outcome measures included T stage, grade, histological sub-type and incidence of node positivity in cN0 and cN+ at presentation. 3 year cancer specific survival was calculated with Kaplan-Meier analysis for the 2 groups. RESULTS 77 SCCmu patients and 882 SCCp were compared. T stage (>pT1) 48% SCCmu vs 35% SCCp. High grade disease 78% SCCmu vs 48% SCCp. Basaloid subtypes SCCmu 58% vs 18.3% SCCp. Node negative (pN0) 49% SCCmu vs 60% SCCp. Extra capsular spread (ECS) 26% SCCmu vs 13.3% SCCp. Sentinel node biopsy positivity rate in cN0 28.8% SCCmu vs 22.3% SCCp. 3 year disease specific survival (DSS) 80.5% SCCmu vs 83.6% SCCp. 3 year DSS in the ECS group 55.9% (95% confidence interval 65.8 - 89.3) SCCmu vs 33.7% (95% confidence interval 9.9 - 57.5) SCCp. CONCLUSIONS SCCmu presents with more advanced disease and worse biological characteristics. Nodal drainage is primarily to inguinal nodes. Although 3 year DSS is similar, in the highest risk nodal group 3 year DSS is better in SCCmu with the same treatment algorithm. Our data supports continuing to manage SCCmu patients with our established SCCp pathway. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e495-e496 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Aditya Manjunath More articles by this author Hussain AlNajjar More articles by this author Catherine Corbishley More articles by this author Benjamin Ayres More articles by this author Nick Watkin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...