Risk of Local Recurrence in Men With Penile Intraepithelial Neoplasia in the Surgical Margin After Penile-sparing Surgery

Esther W C Lee, Luca Antonelli, Allaudin Issa, James Churchill, Ashwin Sachdeva, Pedro Oliveira, Maurice Lau, Vijay Sangar, Arie Parnham, Christian D Fankhauser

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: Up to 90% of men with a positive surgical margin show remaining cancer in subsequent reresections. The risk of local recurrence in men with no penile cancer but the precancerous lesion penile intraepithelial neoplasia at the surgical margin is less well studied and was the aim of this analysis.

MATERIAL AND METHODS: This was a retrospective analysis of men with distal penile cancer undergoing penile-sparing surgery. A competing risks survival analysis adjusted for grade, lymphovascular invasion, and stage was performed to assess local recurrence-free survival in patients with penile intraepithelial neoplasia-positive margins and completely negative surgical margins.

RESULTS: A negative surgical margin was described in 319 men (85%), whereas penile intraepithelial neoplasia in the surgical margin was found in 59 men (15%). Local recurrence was observed in 30/319 men with a negative surgical margin compared to 11/59 men with penile intraepithelial neoplasia in the surgical margin. Adjusted for T stage and grade, patients with penile intraepithelial neoplasia at the surgical margin had a higher risk to develop a local recurrence than those with a negative surgical margin without penile intraepithelial neoplasia (HR 1.51, 95% CI 1.07-2.12, P = .019).

CONCLUSIONS: Men with a penile intraepithelial neoplasia-positive surgical margin have an increased risk to experience local recurrence compared to men with a negative surgical margin and should undergo closer surveillance and/or adjuvant treatment.

Original languageEnglish
Pages (from-to)778-781
Number of pages4
JournalThe Journal of urology
Volume210
Issue number5
Early online date7 Sept 2023
DOIs
Publication statusPublished - 1 Nov 2023

Keywords

  • carcinoma in situ
  • disease-free survival
  • margins of excision
  • neoplasm recurrence, local
  • penile neoplasms

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