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JU INSIGHT Local Recurrence of Penile Intraepithelial Neoplasia in the Surgical Margin After Penile-Sparing Surgery
By: Esther W. C. Lee, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Luca Antonelli, MD, Policlinico Umberto I, Rome, Italy, University of Lucerne, Switzerland; Allaudin Issa, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; James Churchill, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Ashwin Sachdeva, MD, PhD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Pedro Oliveira, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Maurice Lau, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Vijay Sangar, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Arie Parnham, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom; Christian D. Fankhauser, MD, The Christie NHS Foundation Trust, Manchester, United Kingdom, University of Lucerne, Switzerland, University of Zurich, Switzerland, In collaboration with the EAU-YAU Penile and Testis Cancer Working Group | Posted on: 27 Nov 2023
Lee EWC, Antonelli L, Issa A, et al. Risk of local recurrence in men with penile intraepithelial neoplasia in the surgical margin after penile-sparing surgery. J Urol. 2023;210(5):778-781.
Study Need and Importance
Penile cancer is a rare but aggressive cancer with a high mortality rate. Men with a positive surgical margin are at a very high risk for local recurrence. Local recurrence after penile-sparing surgery for penile cancer is associated with metastatic disease and death from penile cancer. Penile intraepithelial neoplasia (PeIN) is a precancerous penile skin lesion that has the potential to progress to invasive penile cancer. However, it is not yet known whether PeIN within the surgical margin is associated with local recurrence.
What We Found
We found that men with PeIN in the surgical margin were more likely to experience local recurrence than men with a negative surgical margin. The hazard ratio for local recurrence was 1.51 (95% CI: 1.07-2.12).
Limitations
The study was retrospective, so there is a risk of bias. The study was also relatively small, so the results may not be generalizable to all men with penile cancer, and external validation is required.
Interpretation for Patient Care
The findings of this study suggest that PeIN in the surgical margin is an independent risk factor for local recurrence. Men with PeIN in the surgical margin should be closely monitored for signs of local recurrence. Further research is needed to determine the best way to manage men with PeIN in the surgical margin.
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