Neoadjuvant Chemotherapy Followed by Aggressive Surgical Consolidation for Metastatic Penile Squamous Cell Carcinoma

Carlos Bermejo, J. Erik Busby, Philippe E. Spiess, Lior Heller, Lance C. Pagliaro, Curtis A. Pettaway

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Purpose: Combination chemotherapy for advanced penile cancer can produce partial response rates of up to 64%. Complete responses are rare, suggesting a need for adjunct therapies to facilitate cure. We evaluated patients with metastases who underwent surgical consolidation after responding to chemotherapy. Materials and Methods: We reviewed the records of 59 patients with advanced penile carcinoma treated from 1985 to 2000 and identified 10 treated with surgical consolidation after demonstrating a stable, partial or complete response to chemotherapy. Presenting tumor burden included pelvic and inguinal metastases. Surgical outcomes and survival were assessed. Results: After chemotherapy 4 patients had a complete response, 1 had a partial response and 5 had stable disease. Three major perioperative complications, including postoperative bleeding, an episode of acute renal failure and deep venous thrombosis in 1 patient each, and 4 minor complications, including skin breakdowns in 3 and wound seroma in 1, occurred. Three cases were rendered pN0. All 3 patients received ifosfamide, paclitaxel and cisplatin chemotherapy. Seven patients had 3 or fewer metastatic lymph nodes following surgery, of whom 4 showed no disease and 3 died. All 3 patients with greater than 3 metastatic lymph nodes died. For all patients the 5-year actuarial survival rate was 40% with a median survival of 26 months. Patients with 3 or fewer and greater than 3 positive nodes had a median survival of 48 and 23 months, respectively (p = 0.116). Conclusions: Select patients with metastatic penile cancer that shows disease stabilization or a response to chemotherapy should be considered for surgical consolidation to extend survival.

Original languageEnglish (US)
Pages (from-to)1335-1338
Number of pages4
JournalJournal of Urology
Volume177
Issue number4
DOIs
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Squamous Cell Carcinoma
Drug Therapy
Penile Neoplasms
Survival
Lymph Nodes
Neoplasm Metastasis
Seroma
Ifosfamide
Groin
Combination Drug Therapy
Tumor Burden
Acute Kidney Injury
Venous Thrombosis
Survival Rate
Hemorrhage
Carcinoma
Skin
Wounds and Injuries

Keywords

  • carcinoma, squamous cell
  • drug therapy
  • lymph nodes
  • penile neoplasms
  • penis

ASJC Scopus subject areas

  • Urology

Cite this

Bermejo, C., Busby, J. E., Spiess, P. E., Heller, L., Pagliaro, L. C., & Pettaway, C. A. (2007). Neoadjuvant Chemotherapy Followed by Aggressive Surgical Consolidation for Metastatic Penile Squamous Cell Carcinoma. Journal of Urology, 177(4), 1335-1338. https://doi.org/10.1016/j.juro.2006.11.038

Neoadjuvant Chemotherapy Followed by Aggressive Surgical Consolidation for Metastatic Penile Squamous Cell Carcinoma. / Bermejo, Carlos; Busby, J. Erik; Spiess, Philippe E.; Heller, Lior; Pagliaro, Lance C.; Pettaway, Curtis A.

In: Journal of Urology, Vol. 177, No. 4, 04.2007, p. 1335-1338.

Research output: Contribution to journalArticle

Bermejo, C, Busby, JE, Spiess, PE, Heller, L, Pagliaro, LC & Pettaway, CA 2007, 'Neoadjuvant Chemotherapy Followed by Aggressive Surgical Consolidation for Metastatic Penile Squamous Cell Carcinoma', Journal of Urology, vol. 177, no. 4, pp. 1335-1338. https://doi.org/10.1016/j.juro.2006.11.038
Bermejo, Carlos ; Busby, J. Erik ; Spiess, Philippe E. ; Heller, Lior ; Pagliaro, Lance C. ; Pettaway, Curtis A. / Neoadjuvant Chemotherapy Followed by Aggressive Surgical Consolidation for Metastatic Penile Squamous Cell Carcinoma. In: Journal of Urology. 2007 ; Vol. 177, No. 4. pp. 1335-1338.
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