Penile cancer: a Brazilian consensus statement for low- and middle-income countries
- PDF / 2,303,025 Bytes
- 16 Pages / 595.276 x 790.866 pts Page_size
- 118 Downloads / 183 Views
REVIEW – CLINICAL ONCOLOGY
Penile cancer: a Brazilian consensus statement for low‑ and middle‑income countries Andrey Soares1,2,3 · Icaro Thiago de Carvalho4,5 · Aluízio Gonçalves da Fonseca6 · Antonio Machado Alencar Jr.7,8 · Carlos Heli Bezerra Leite9 · Diogo Assed Bastos3,10 · João Paulo Holanda Soares11 · Katia Ramos Moreira Leite12 · Mário Ronalsa Brandão Filho13 · Ronald Wagner Pereira Coelho3,14 · Sandro Roberto de A. Cavallero3,15,16 · Stênio de Cassio Zequi17,18 · José de Ribamar Rodrigues Calixto19 Received: 5 May 2020 / Accepted: 29 September 2020 © The Author(s) 2020
Abstract Purpose Penile cancer is highly prevalent in low- and middle-income countries, with significant morbidity and mortality rates. The first Brazilian consensus provides support to improve penile cancer patients’ outcomes, based on expert’s opinion and evidence from medical literature. Methods Fifty-one Brazilian experts (clinical oncologists, radiation oncologists, urologists, and pathologists) assembled and voted 104 multiple-choice questions, confronted the results with the literature, and ranked the levels of evidence. Results Healthcare professionals need to deliver more effective communication about the risk factors for penile cancer. Staging and follow-up of patients include physical examination, computed tomography, and magnetic resonance imaging. Close monitoring is crucial, because most recurrences occur in the first 2–5 years. Lymph-node involvement is the most important predictive factor for survival, and management depends on the location (inguinal or pelvic) and the number of lymph nodes involved. Conservative treatment may be helpful in selected patients without compromising oncological outcomes; however, surgery yields the lowest rate of local recurrence. Conclusion This consensus provides an essential decision-making orientation regarding this challenging disease. Keywords Penile cancer · HPV cancer-related · Cancer consensus · Urologic malignancy
Introduction Penile cancer is rare in developed countries, but the incidence tends to be higher in developing countries such as Africa, Asia, and South America (GLOBOCAN 2019). Brazil registered 5.7 cases per 100,000 persons-year between 1996 and 2006, and has the third highest incidence worldwide of penile cancer (Cardona and García-Perdomo 2017). More than 50% of penile cancer cases in Brazil occur in the North and Northeastern areas, confirming the relationship between penile cancer and low socioeconomic status (Favorito et al. 2008). Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00432-020-03417-1) contains supplementary material, which is available to authorized users.
Penile cancer is highly aggressive (Razzaghi et al. 2018; Pham et al. 2017); thus, timely diagnosis and treatment are crucial. Patients’ low educational level and limited access to healthcare in low- and middle-income countries delay the diagnosis, resulting in patients receiving care in more advanced stages. Actions to prevent, to simpli
Data Loading...
