Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer

Curtis A. Pettaway, Lance Pagliaro, Christine Theodore, Gabriel Haas

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: To review the treatment strategies among patients with Stage IV penile cancer to describe potentially curative or palliative therapy. Methods: The International Consultation on Urologic Disease for Penile Cancer subcommittee on the treatment of Stage IV penile cancer reviewed reports related to the topics of advanced penile cancer and metastatic penile cancer alone and combined with chemotherapy, radiotherapy, and inguinal lymphadenectomy. The reports were rated as to their level of evidence using the criteria of the Oxford Centre for evidence-based medicine. Treatment recommendations were made by consensus, with the appropriate grades determined from the level of evidence. Results: The incidence of Stage IV disease using the current or modified TNM or Jackson descriptions was 0%-14%. Cisplatin-containing regimens were the most active, with patients exhibiting an average response and survival rate of 26% (range 15%-32%) and 5.5 months (range 4.7-7), respectively. Bleomycin-containing regimens were associated with significant pulmonary toxicity. The role of radiotherapy for advanced penile cancer has been largely palliative. Data have suggested that surgical consolidation among patients exhibiting an objective response to chemotherapy could be associated with durable survival. Conclusions: Treatment with a cisplatin-containing regimen in Stage IV penile cancer should be considered and might facilitate curative resection. The use of bleomycin was associated with a high level of toxicity and should be discouraged as first-line therapy. Surgical consolidation to achieve disease-free status or palliation should be considered in fit patients with an objective response to systemic chemotherapy. Palliative radiotherapy to inguinal or skeletal metastases might be of benefit.

Original languageEnglish (US)
JournalUrology
Volume76
Issue numberSUPPL. 2
DOIs
StatePublished - Aug 2010
Externally publishedYes

Fingerprint

Penile Neoplasms
Neoplasm Metastasis
Radiotherapy
Groin
Bleomycin
Drug Therapy
Cisplatin
Therapeutics
Urologic Diseases
Evidence-Based Medicine
Lymph Node Excision
Palliative Care
Referral and Consultation
Survival Rate
Lung
Survival
Incidence

ASJC Scopus subject areas

  • Urology

Cite this

Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer. / Pettaway, Curtis A.; Pagliaro, Lance; Theodore, Christine; Haas, Gabriel.

In: Urology, Vol. 76, No. SUPPL. 2, 08.2010.

Research output: Contribution to journalArticle

Pettaway, Curtis A. ; Pagliaro, Lance ; Theodore, Christine ; Haas, Gabriel. / Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer. In: Urology. 2010 ; Vol. 76, No. SUPPL. 2.
@article{fd6608e648da4c6da95ab8d503161de4,
title = "Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer",
abstract = "Objectives: To review the treatment strategies among patients with Stage IV penile cancer to describe potentially curative or palliative therapy. Methods: The International Consultation on Urologic Disease for Penile Cancer subcommittee on the treatment of Stage IV penile cancer reviewed reports related to the topics of advanced penile cancer and metastatic penile cancer alone and combined with chemotherapy, radiotherapy, and inguinal lymphadenectomy. The reports were rated as to their level of evidence using the criteria of the Oxford Centre for evidence-based medicine. Treatment recommendations were made by consensus, with the appropriate grades determined from the level of evidence. Results: The incidence of Stage IV disease using the current or modified TNM or Jackson descriptions was 0{\%}-14{\%}. Cisplatin-containing regimens were the most active, with patients exhibiting an average response and survival rate of 26{\%} (range 15{\%}-32{\%}) and 5.5 months (range 4.7-7), respectively. Bleomycin-containing regimens were associated with significant pulmonary toxicity. The role of radiotherapy for advanced penile cancer has been largely palliative. Data have suggested that surgical consolidation among patients exhibiting an objective response to chemotherapy could be associated with durable survival. Conclusions: Treatment with a cisplatin-containing regimen in Stage IV penile cancer should be considered and might facilitate curative resection. The use of bleomycin was associated with a high level of toxicity and should be discouraged as first-line therapy. Surgical consolidation to achieve disease-free status or palliation should be considered in fit patients with an objective response to systemic chemotherapy. Palliative radiotherapy to inguinal or skeletal metastases might be of benefit.",
author = "Pettaway, {Curtis A.} and Lance Pagliaro and Christine Theodore and Gabriel Haas",
year = "2010",
month = "8",
doi = "10.1016/j.urology.2010.03.082",
language = "English (US)",
volume = "76",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer

AU - Pettaway, Curtis A.

AU - Pagliaro, Lance

AU - Theodore, Christine

AU - Haas, Gabriel

PY - 2010/8

Y1 - 2010/8

N2 - Objectives: To review the treatment strategies among patients with Stage IV penile cancer to describe potentially curative or palliative therapy. Methods: The International Consultation on Urologic Disease for Penile Cancer subcommittee on the treatment of Stage IV penile cancer reviewed reports related to the topics of advanced penile cancer and metastatic penile cancer alone and combined with chemotherapy, radiotherapy, and inguinal lymphadenectomy. The reports were rated as to their level of evidence using the criteria of the Oxford Centre for evidence-based medicine. Treatment recommendations were made by consensus, with the appropriate grades determined from the level of evidence. Results: The incidence of Stage IV disease using the current or modified TNM or Jackson descriptions was 0%-14%. Cisplatin-containing regimens were the most active, with patients exhibiting an average response and survival rate of 26% (range 15%-32%) and 5.5 months (range 4.7-7), respectively. Bleomycin-containing regimens were associated with significant pulmonary toxicity. The role of radiotherapy for advanced penile cancer has been largely palliative. Data have suggested that surgical consolidation among patients exhibiting an objective response to chemotherapy could be associated with durable survival. Conclusions: Treatment with a cisplatin-containing regimen in Stage IV penile cancer should be considered and might facilitate curative resection. The use of bleomycin was associated with a high level of toxicity and should be discouraged as first-line therapy. Surgical consolidation to achieve disease-free status or palliation should be considered in fit patients with an objective response to systemic chemotherapy. Palliative radiotherapy to inguinal or skeletal metastases might be of benefit.

AB - Objectives: To review the treatment strategies among patients with Stage IV penile cancer to describe potentially curative or palliative therapy. Methods: The International Consultation on Urologic Disease for Penile Cancer subcommittee on the treatment of Stage IV penile cancer reviewed reports related to the topics of advanced penile cancer and metastatic penile cancer alone and combined with chemotherapy, radiotherapy, and inguinal lymphadenectomy. The reports were rated as to their level of evidence using the criteria of the Oxford Centre for evidence-based medicine. Treatment recommendations were made by consensus, with the appropriate grades determined from the level of evidence. Results: The incidence of Stage IV disease using the current or modified TNM or Jackson descriptions was 0%-14%. Cisplatin-containing regimens were the most active, with patients exhibiting an average response and survival rate of 26% (range 15%-32%) and 5.5 months (range 4.7-7), respectively. Bleomycin-containing regimens were associated with significant pulmonary toxicity. The role of radiotherapy for advanced penile cancer has been largely palliative. Data have suggested that surgical consolidation among patients exhibiting an objective response to chemotherapy could be associated with durable survival. Conclusions: Treatment with a cisplatin-containing regimen in Stage IV penile cancer should be considered and might facilitate curative resection. The use of bleomycin was associated with a high level of toxicity and should be discouraged as first-line therapy. Surgical consolidation to achieve disease-free status or palliation should be considered in fit patients with an objective response to systemic chemotherapy. Palliative radiotherapy to inguinal or skeletal metastases might be of benefit.

UR - http://www.scopus.com/inward/record.url?scp=77955540427&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955540427&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2010.03.082

DO - 10.1016/j.urology.2010.03.082

M3 - Article

VL - 76

JO - Urology

JF - Urology

SN - 0090-4295

IS - SUPPL. 2

ER -