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Penile, Urethral, and Scrotal Cancer, An Issue of Urologic Clinics of North America, E-Book

Penile, Urethral, and Scrotal Cancer, An Issue of Urologic Clinics of North America, E-Book

Philippe E. Spiess

(2016)

Additional Information

Book Details

Abstract

The Editor has assembled top experts to write authoritative reviews on the latest advances in the diagnosis and treatment of penile, urethral, and scrotal cancers. The issue stresses contrasting approaches and includes articles devoted to the following topics: radiation in primary urethral cancers; the role of node dissection; role of HPV in penile pre-neoplastic and carcinogenesis; advances in penile-sparing surgical approaches in the management of primary penile tumors; minimally invasive approaches to evaluating inguinal nodes in penile cancer patients; multimodal therapy in the management of advanced penile cancer; management of urethral cancer recurrences; Preneoplastic and primary scrotal cancer; and Advances in surgical reconstructive techniques in the management of penile, urethral, and scrotal cancer. The state-of-the article clinical and surgical details in this issue will keep urologists and other healthcare professionals current on the clinical management of these cancers.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Penile, Urethral,and Scrotal Cancer i
Copyright\r ii
CME Accreditation Page iii
PROGRAM OBJECTIVE iii
TARGET AUDIENCE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iii
TO ENROLL iii
METHOD OF PARTICIPATION iv
CME INQUIRIES/SPECIAL NEEDS iv
Contributors v
CONSULTING EDITOR v
EDITOR v
AUTHORS v
Foreword: Penile, Urethral, and Scrotal Cancer\r ix
Preface: Penile, Urethral, and Scrotal Cancer\r ix
The Role of Human Papilloma Virus in Penile Carcinogenesis and Preneoplastic Lesions: A Potential Target for Vaccination an\r ix
Advances in Penile-Preserving Surgical Approaches in the Management of Penile Tumors\r ix
Contemporary Role of Radiotherapy in the Management of Primary Penile Tumors and Metastatic Disease\r ix
Minimal Invasive Management of Lymph Nodes\r x
Surgical Advances in Inguinal Lymph Node Dissection: Optimizing Treatment Outcomes\r x
Multimodal Therapy in the Management of Advanced Penile Cancer\r x
Emerging Systemic Therapies for the Management of Penile Cancer\r x
Contemporary Management of Primary Distal Urethral Cancer\r xi
Management of Proximal Primary Urethral Cancer: Should Multidisciplinary Therapy Be the Gold Standard?\r xi
Management of Urethral Recurrences: Urothelial and Nonurothelial\r xi
Preneoplastic and Primary Scrotal Cancer: Updates on Pathogenesis and Diagnostic Evaluation\r xi
Surgical Management of Primary Scrotal Cancer\r xi
Advances in Surgical Reconstructive Techniques in the Management of Penile, Urethral, and Scrotal Cancer\r xii
Index\r xii
UROLOGIC CLINICS OF NORTH AMERICA\r\x0B xiii
FORTHCOMING ISSUES xiii
February 2017 xiii
May 2017 xiii
August 2017 xiii
RECENT ISSUES xiii
August 2016 xiii
May 2016 xiii
February 2016 xiii
Foreword:\rPenile, Urethral, and Scrotal Cancer xv
Preface:\rPenile, Urethral, and Scrotal Cancer xvii
The Role of Human Papilloma Virus in Penile Carcinogenesis and Preneoplastic Lesions 419
Key points 419
INTRODUCTION 419
HUMAN PAPILLOMAVIRUS PATHOGENESIS AND PENILE CANCER 420
HUMAN PAPILLOMAVIRUS PREVALENCE AND PENILE CANCER 420
HUMAN PAPILLOMAVIRUS AND PRENEOPLASTIC LESIONS 421
HUMAN PAPILLOMAVIRUS VACCINATION STRATEGIES IN MEN 421
TARGETED THERAPIES IN HUMAN PAPILLOMAVIRUS–ASSOCIATED MALIGNANCY 422
SUMMARY 424
REFERENCES 424
Advances in Penile-Preserving Surgical Approaches in the Management of Penile Tumors 427
Key points 427
WHAT IS AN ONCOLOGICALLY SAFE MARGIN? 427
WHAT SURGICAL OPTIONS ARE AVAILABLE BY DISEASE STAGE? 428
For Lesions Confined to the Prepuce: Circumcision 428
For Glanular Lesions up to T1a 428
Glans resurfacing 428
Laser therapy 429
Mohs micrographic surgery 429
Wide local excision/partial glansectomy 430
Stage T1b/T2 Tumors Confined to the Glans: Glansectomy 430
Stage 2b/Distal T3 Disease: Partial Penectomy/Distal Corporectomy 430
WHAT IF THE TUMOR/PEIN EXTENDS INTO THE GLANULAR URETHRA? 432
IS THERE A ROLE FOR PENILE-PRESERVING SURGERY IN SALVAGE TREATMENT? 433
DOES PENILE-PRESERVING SURGERY AFFECT SURVIVAL? 433
SUMMARY 433
REFERENCES 433
Contemporary Role of Radiotherapy in the Management of Primary Penile Tumors and Metastatic Disease 435
Key points 435
INTRODUCTION 435
RADIOTHERAPY FOR THE PRIMARY TUMOR 436
CARCINOMA IN SITU 436
INVASIVE CANCER 436
External Beam Radiotherapy 436
Interstitial Low-Dose Rate Brachytherapy 438
High-Dose Rate Interstitial Brachytherapy 439
Surface Mold Plesiotherapy 441
Patient selection 441
Aftercare 442
Late Toxicity 442
Regional Radiotherapy 443
COMBINED CHEMORADIOTHERAPY 443
Palliative Treatment 445
SUMMARY 445
REFERENCES 446
Minimal Invasive Management of Lymph Nodes 449
Key points 449
INTRODUCTION 449
ASSESSMENT OF INGUINAL LYMPH NODES 449
CLINICAL EXAMINATION OF THE NODES 450
ULTRASOUND WITH FINE-NEEDLE ASPIRATION CYTOLOGY 450
COMPUTED TOMOGRAPHY IMAGING 450
MAGNETIC RESONANCE IMAGING 450
POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY SCAN 450
ASSESSMENT OF THE PELVIC LYMPH NODES 451
MINIMALLY INVASIVE STAGING TECHNIQUES 451
MODIFIED INGUINAL LYMPHADENECTOMY 451
SENTINEL NODE BIOPSY 452
TECHNIQUE OF DYNAMIC SENTINEL NODE BIOPSY 452
SETTINGS FOR DYNAMIC SENTINEL NODE BIOPSY 453
RELIABILITY 454
STAGING RECOMMENDATIONS 454
REFERENCES 455
Surgical Advances in Inguinal Lymph Node Dissection 457
Key points 457
INTRODUCTION 457
CLINICAL INDICATIONS FOR LYMPH NODE DISSECTION 458
RADICAL INGUINAL LYMPH NODE DISSECTION 459
MODIFIED INGUINAL LYMPH NODE DISSECTION 461
SALVAGE INGUINAL LYMPH NODE DISSECTION 462
SKIN AND SOFT TISSUE COVERAGE AFTER INGUINAL LYMPH NODE DISSECTION 462
MINIMALLY INVASIVE LYMPH NODE DISSECTION 463
PELVIC LYMPH NODE DISSECTION 463
SURVEILLANCE STRATEGIES FOLLOWING LYMPHADENECTOMY 464
SUMMARY 465
REFERENCES 465
Multimodal Therapy in the Management of Advanced Penile Cancer 469
Key points 469
INTRODUCTION 469
ADJUVANT CHEMOTHERAPY IN NODE-POSITIVE DISEASE 469
Summary 471
MULTIMODAL APPROACH TO BULKY OR UNRESECTABLE NODAL DISEASE 472
Summary 474
IS THERE A ROLE FOR CHEMORADIOTHERAPY? 476
THE NEED FOR MULTICENTER COLLABORATION 476
SUMMARY 476
REFERENCES 478
Emerging Systemic Therapies for the Management of Penile Cancer 481
Key points 481
INTRODUCTION 481
SYSTEMIC CHEMOTHERAPY 482
Chemotherapy for Advanced/Metastatic Penile Squamous Cell Carcinoma 482
First-line chemotherapy 482
Salvage chemotherapy 483
Neoadjuvant Chemotherapy 484
Adjuvant Chemotherapy 484
RECENT INSIGHTS REGARDING TUMOR BIOLOGY FROM GENOMIC STUDIES OF PENILE SQUAMOUS CELL CARCINOMA 485
NOVEL SYSTEMIC REGIMENS 486
Targeted Therapies 486
Epidermal growth factor receptor inhibitors 486
Vascular endothelial growth factor inhibitors 486
Immunotherapy 486
Active immunotherapy 486
T-cell checkpoint signaling pathway inhibitors 488
SUMMARY 488
REFERENCES 488
Contemporary Management of Primary Distal Urethral Cancer 493
Key points 493
INTRODUCTION 493
Epidemiology 493
Etiology 493
Anatomic Histopathology 493
PATIENT EVALUATION OVERVIEW 494
Clinical Presentation 494
Clinical Evaluation 494
Urine Cytology 494
Urethrocystoscopy 495
Imaging 495
PHARMACOLOGIC TREATMENT OPTIONS 496
SURGICAL TREATMENT OPTIONS IN MEN 496
RADIATION THERAPY IN MEN 497
COMBINATION THERAPIES IN MEN 497
SURGICAL TREATMENT OPTIONS IN WOMEN 498
RADIATION THERAPY IN WOMEN 498
COMBINATION THERAPIES IN WOMEN 499
LYMPH NODES MANAGEMENT 499
COMPLICATIONS 499
EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS 499
SUMMARY 501
REFERENCES 501
Management of Proximal Primary Urethral Cancer 505
Key points 505
INTRODUCTION 505
Epidemiology 505
Etiology 505
Histology 506
Staging and Classification Systems 506
DIAGNOSIS 506
Presentation 506
Physical Examination 507
Tissue Diagnosis 507
Imaging 507
Prognosis 507
TREATMENT OF PROXIMAL PRIMARY URETHRAL CANCER 507
Urothelial Carcinoma of the Prostate 507
Transurethral Resection and Bacillus Calmette-Guérin 508
Radical Cystoprostatectomy 508
MULTIMODAL THERAPY VERSUS MONOTHERAPY FOR PROXIMAL URETHRAL CANCER 508
Monotherapy 508
Multimodal Therapy 509
Surgery and Adjuvant Radiotherapy 509
Radiation Therapy and Surgery 509
Perioperative Chemotherapy 509
Chemoradiotherapy and Salvage Surgery 509
SUMMARY 511
REFERENCES 511
Management of Urethral Recurrences 515
Key points 515
INTRODUCTION 515
URETHRAL RECURRENCE AFTER CYSTECTOMY 515
URETHRAL RECURRENCE FOLLOWING NONUROTHELIAL CARCINOMA 518
RECURRENCE FOLLOWING TREATMENT OF PRIMARY URETHRAL CARCINOMA 518
TREATMENT OPTIONS IN FEMALES WITH RECURRENT URETHRAL CARCINOMA 518
MULTIMODAL THERAPY: THE ROLE OF RADIATION AND CHEMOTHERAPY 519
SUMMARY 519
REFERENCES 519
Preneoplastic and Primary Scrotal Cancer 523
Key points 523
INTRODUCTION 523
PRENEOPLASTIC SQUAMOUS LESIONS AND SQUAMOUS CELL CARCINOMA 523
Pathogenesis 523
Diagnostic Evaluation 524
EXTRAMAMMARY PAGET’S DISEASE 525
Pathogenesis 525
Diagnostic Evaluation 526
BASAL CELL CARCINOMA 527
Pathogenesis 527
Diagnostic Evaluation 527
SUMMARY 528
REFERENCES 528
Surgical Management of Primary Scrotal Cancer 531
Key points 531
INTRODUCTION 531
TECHNIQUE/PROCEDURE 532
Preparation 532
Scrotal anatomy 532
Preoperative prophylactic antibiotic and infection management 532
Patient Positioning 532
Approach 533
General thoughts regarding surgical excision 533
General thoughts regarding reconstruction 533
Technique and Procedure (Detailed Steps) 533
Squamous cell carcinoma 533
Extramammary Paget’s disease 533
Sarcoma 533
Basal cell carcinoma 534
Melanoma 534
Adnexal tumors 535
Case report 535
POSTOPERATIVE CARE 537
REPORTING, FOLLOW-UP, AND CLINICAL IMPLICATIONS 539
OUTCOMES 539
CURRENT CONTROVERSIES AND FUTURE CONSIDERATIONS 542
SUMMARY 543
REFERENCES 543
Advances in Surgical Reconstructive Techniques in the Management of Penile, Urethral, and Scrotal Cancer 545
Key points 545
PENILE CANCER 545
Reconstruction of the Penis Based on Type and Extent of Penile Malignancy 545
Carcinoma In Situ, Ta, and T1 of the Penis 546
Glans Resurfacing 546
Mohs Surgery for Carcinoma In Situ, Ta, and T1 546
Reconstructive Options Following Total Penectomy 549
Radial Artery Free Flap Phalloplasty 550
Additional Flap Techniques 552
Radial and Fibular Osteocutaneous Free Flaps 552
Penile Prosthesis in Phalloplasty Patients 552
Tissue Engineering in Phallic Regeneration 553
Penile Transplantation 554
SCROTAL CANCER RECONSTRUCTION 554
PRIMARY URETHRAL CARCINOMA 555
REFERENCES 557
Index 561