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The role of primary inguinal surgical debulking for locally advanced penile cancer followed by reconstruction with myocutaneous flap.
Koifman, Leandro; Hampl, Daniel; Ginsberg, Marcio; Castro, Rodrigo Barros; Koifman, Nelson; Ornellas, Paulo; Ornellas, Antonio Augusto.
Afiliação
  • Koifman L; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
  • Hampl D; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
  • Ginsberg M; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
  • Castro RB; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
  • Koifman N; Departamento de Urologia, Instituto Nacional de Câncer - INCA , Rio de Janeiro, RJ, Brasil.
  • Ornellas P; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
  • Ornellas AA; Serviço de Urologia, Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ, Brasil.
Int Braz J Urol ; 47(6): 1162-1175, 2021.
Article em En | MEDLINE | ID: mdl-34115458
PURPOSE: To evaluate surgical complications and oncological outcomes of patients submitted to primary radical inguinal surgical debulking (PRISD) and myocutaneous pediculate flap reconstruction (MPFR) for locally advanced penile cancer (PC). MATERIALS AND METHODS: Forty-two patients with ulcerated and/or fixed bulky inguinal masses underwent unilateral or bilateral PRISD with MPFR. Tensor fascia lata flap (TFL) was the standard of care for all patients. Additional use of the gracilis flap (GF) was carried out when necessary. Contra-lateral radical inguinal lymphadenectomy (RIL) was conduced when PRISD was performed unilaterally. Surgical complications were analyzed and stratified into minor and major according to the Bevan-Thomas classification. Adjunctive treatments were assessed and oncological outcomes analyzed. RESULTS: Of the 42 patients evaluated, 10 (23.8%) underwent bilateral PRISD and 32 (76.2%) unilateral PRISD with contra-lateral RIL, totaling 84 lymphadenectomies. A total of 62 MPFRs were performed, 52 with TFL and 10 with GF. A total of 53 complications were identified, 49 related to PRISD with MPFR and 4 to RIL. Adjuvant chemotherapy was carried out in 16 patients. Median follow-up was 10.8 months with a median overall survival (OS) of 14.0 months against 6.0 months (p=0.006) for patients submitted to PRISD with adjuvant chemotherapy in relation to surgery alone. CONCLUSIONS: PRISD alone for advanced loco-regional PC is unlikely to promote long-term survival, although it can lead to temporary local control of the disease. Despite the feasibility of the procedure, it is related to high incidence of complications. Surgical treatment with adjuvant chemotherapy is associated with improved OS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Penianas / Procedimentos de Cirurgia Plástica / Retalho Miocutâneo Limite: Humans / Male Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Penianas / Procedimentos de Cirurgia Plástica / Retalho Miocutâneo Limite: Humans / Male Idioma: En Revista: Int Braz J Urol Assunto da revista: UROLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil