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OBJECTIVE: To evaluate the mortality rates for prostate cancer according to geographical areas in Peru between 2005 and 2014. MATERIALS AND METHODS: Information was extracted from the Deceased Registry of the Peruvian Ministry of Health. We analysed age-standardised mortality rates (world population) per 100 000 men. Spatial autocorrelation was determined according to the Moran Index. In addition, we used Cluster Map to explore relations between regions. RESULTS: Mortality rates increased from 20.9 (2005-2009) to 24.1 (2010-2014) per 100 000 men, an increase of 15.2%. According to regions, during the period 2010-2014, the coast had the highest mortality rate (28.9 per 100 000), whilst the rainforest had the lowest (7.43 per 100 000). In addition, there was an increase in mortality in the coast and a decline in the rainforest over the period 2005-2014. The provinces with the highest mortality were Piura, Lambayeque, La Libertad, Callao, Lima, Ica, and Arequipa. Moreover, these provinces (except Arequipa) showed increasing trends during the years under study. The provinces with the lowest observed prostate cancer mortality rates were Loreto, Ucayali, and Madre de Dios. This study showed positive spatial autocorrelation (Moran's I: 0.30, P = 0.01). CONCLUSION: Mortality rates from prostate cancer in Peru continue to increase. These rates are higher in the coastal region compared to those in the highlands or rainforest.
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Neoplasias de la Próstata/mortalidad , Sistema de Registros/estadística & datos numéricos , Adulto , Geografía , Disparidades en el Estado de Salud , Humanos , Masculino , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Análisis EspacialRESUMEN
OBJECTIVES: The objective was to submit our first experience in endoscopic inguinal lymphadenectomy (EIL), evaluate the feasibility of the procedure and carry out a review of the literature. MATERIAL AND METHODS: A 41-year-old patient was diagnosed with penile cancer with squamous cell carcinoma pT2G1 pathology, with no palpable inguinal lymph nodes. A bilateral inguinal lymphadenectomy was performed with preservation of the saphenous vein, conventional left and endoscopic right procedures. The perioperative data is presented and that obtained is discussed in the literature. RESULTS: The total time was 270 minutes, 180 for endoscopic and 90 for conventional procedures. Blood loss was minimal in both cases. Fifteen lymph nodes were dissected on the endoscopic side, and 17 in the conventional side, the latter with more pain and devitalised skin flap. CONCLUSIONS: EIL for penile cancer is feasible and there is less morbidity with an early recovery. The literature is not conclusive on the indication of EIL.
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Early detection of prostate cancer in Peru is very uncommon, as patients usually arrive when the disease is locally advanced or advanced. There are no prostate cancer screening campaigns that allow us to detect this disease in early stages. The incidence rates, according to the Registry of Cancer in Metropolitan Lima, are increasing. However, there is probably an under register of cases in our country, since there are not any nation-wide records showing the real magnitude of this disease. It is imperative to develop prevention programs for the early diagnosis of prostate cancer through digital rectal exams and to perform the measurement of the prostate- specific antigen (PSA) in the blood.
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Neoplasias de la Próstata/diagnóstico , Diagnóstico Precoz , Humanos , Masculino , PerúRESUMEN
La detección temprana del cáncer de próstata en el Perú es muy baja, ya que los pacientes, por lo general, llegan con la enfermedad localmente avanzada o avanzada. No existen campañas de tamizaje del cáncer de próstata que nos permitan detectar esta enfermedad en estadios tempranos. Las tasas de incidencia, según el Registro de Cáncer de Lima Metropolitana, van en aumento, a pesar de existir probablemente un subregistro en nuestro país, al no contar con un registro a nivel nacional que muestre la real magnitud de esta enfermedad. Es imperativo generar programas de prevención para el diagnóstico temprano del cáncer de próstata mediante el examen digito-rectal de la próstata y el dosaje del antígeno prostático específico (PSA) en sangre.
Early detection of prostate cancer in Peru is very uncommon, as patients usually arrive when the disease is locally advanced or advanced. There are no prostate cancer screening campaigns that allow us to detect this disease in early stages. The incidence rates, according to the Registry of Cancer in Metropolitan Lima, are increasing. However, there is probably an under register of cases in our country, since there are not any nation-wide records showing the real magnitude of this disease. It is imperative to develop prevention programs for the early diagnosis of prostate cancer through digital rectal exams and to perform the measurement of the prostate- specific antigen (PSA) in the blood.
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Humanos , Masculino , Neoplasias de la Próstata/diagnóstico , Diagnóstico Precoz , PerúRESUMEN
An extensive literature search was performed using the key words squamous cell carcinoma of the penis, phimosis, circumcision, chronic balanitis, cigarette smoking, genital warts and human papillomavirus (HPV) infection. All selected studies were classified according to the level of evidence (LE). The final grades of recommendation were assigned after discussion by the full panel of the International Consultation on Penile Cancer in November 2008. The factors positively associated with invasive penile cancers include the presence of phimosis (LE 3a), tobacco smoking (LE 3a-4), chewing tobacco (LE 3a), injury to the penis (LE 3a), balanitis (LE 3a), genital warts (LE 3a), and high-risk HPV infection (LE 3a-4).
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Neoplasias del Pene , Progresión de la Enfermedad , Humanos , Masculino , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/epidemiología , Neoplasias del Pene/etiología , Factores de RiesgoRESUMEN
There is a very low rate of early prostate cancer detection in Latin America, since patients usually are diagnosed when the disease is in advanced stages. Sporadic prostate cancer screening campaigns do exist which allow us to diagnose this disease in earlier stages. Incidence and mortality rates differ widely from country to country, and they are probable underreported in our region since registers may be city-based instead of country-based.
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Neoplasias de la Próstata/epidemiología , Humanos , América Latina/epidemiología , MasculinoRESUMEN
BACKGROUND: Cancer of the penis is an uncommon malignancy in developed countries, but the incidence is as high as 17% of all male cancers in some undeveloped countries. The surgical management of this disease has improved due to better knowledge of risk for metastasis and newer imaging technologies to assess the regional lymph nodes. METHODS: We review the literature on incidence, etiology, pathology, clinical presentation, staging, and management of penile cancer. We present our institutional experience with 160 patients who underwent extended ilioinguinal lymph node dissection, as well as with 7 patients who underwent a modified lymph node dissection. RESULTS: Better understanding of pathologic features allow for stratification of patients into low, intermediate, or high risk for lymph node involvement. Lymphatic mapping to this stratification improves selection of patients who might benefit from lymph node dissection after excision of the primary lesion. Our experience with lymph node dissection yielded a high incidence of positive lymph nodes when lymphadenopathy was present. The recent use of a modified lymph node dissection has minimized morbidity. Current chemotherapy agents are ineffective in this disease. CONCLUSIONS: Pathologic features of the primary lesion and the incorporation of lymphatic mapping have improved the selection of patients who might benefit from lymph node dissection. The use of a modified lymph node dissection in selected patients has decreased morbidity. Effective chemotherapy agents are needed in the management of advanced penile cancer.