Cáncer de pene en México: 20 años de experiencia en un hospital académico de tercer nivel / Penile cancer in Mexico: Twenty years experience at a tertiary academic hospital

OBJETIVO: Revisar las características clínicas y el manejo del cáncer de pene (CP) en el Instituto Nacional de Cancerología (INCan) de la Ciudad de México en 20 años de experiencia. MATERIAL Y MÉTODOS: Revisamos de forma retrospectiva a 405 pacientes con diagnóstico de CP tratados en INCan entre enero de 1989 hasta diciembre de 2015. Se describieron la modalidad de presentación de los casos, los resultados de patología, tratamiento y la sobrevida. RESULTADOS: Las informaciones clínico-patológicas y los resultados oncológicos fueron completas en 375 pacientes (edad media 56,82). Al diagnóstico 140 casos (n.37,3%) fueron cN0, 71 casos (18,9%) cN1, 164 casos (43,37%) cN2, 33 casos (8%) cN3. El 14% tuvieron metástasis a distancia (pulmón, huesos). El tratamiento inicial incluyó falectomía parcial (n = 123; 33,6% y falectomía total (n = 126; 33,6%). De 138 (36,2%) pacientes de alto riesgo sometidos a disección de ganglios linfáticos inguinales bilaterales, solo el 8% (n.56) tenían ganglios linfáticos positivos. El análisis de supervivencia de Kaplan-Meier mostró una tasa de SCE (sobrevida cáncer específica) a 10 años del 70%. No hubo diferencias significativas en la supervivencia para el grupo de edad. La CSS a 5 años para pT1, pT2, pT3 y T4 fue del 96%, 88%, 58% y 0%, respectivamente. Se encontró diferencia en la supervivencia entre pT2 y pT3 (p 0,047). CONCLUSIÓN: Los hallazgos de nuestra casuística proporcionan información sobre la historia natural del cáncer de pene en México. La amputación quirúrgica del tumor primario sigue siendo el patrón uro-oncológico para el tratamiento definitivo del CP. No hubo diferencias en la supervivencia para el grupo de edad

OBJECTIVE: The aim of this study was to report clinical features and management of penile cancer (CP) at the National Cancer Institute (INCan) of Mexico City over 20 years. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 405 cases of primary penile cancer (PC) treated at our institution between 1989 until 2015. Diagnosis, treatment and oncological outcomes are reported. RESULTS: Clinicopathologic and demographic information was available for 375 patients (mean age, 56 ys). At diagnosis, 140 (37.3 %) patients were cN0, 71(18.9%) cN1, 164 (43.37%) cN2 and 33 (8%) cN3. 14% had metastatic disease (lung and bone). Initial treatment included partial penectomy (n = 123; 33.6%), and total penectomy (n = 126;33.6%). 138 (36.2%) patients with high risk disease underwent bilateral inguinal lymph node dissection. 8% (56) had positive lymph nodes. Kaplan-Meier survival analysis showed a 10-year CSS (cancer specific survival) rate of 70%. There was no significant difference in CSS when stratifying per age. Five-year CSS for pT1, pT2, pT3 and T4 was 96%, 88%, 58% y T4 0%, respectively. A difference in CSS was found between pT2 and pT3 (p = 0.047). CONCLUSION: The findings of our descriptive análisis provide information on natural history of penile cancer in Mexico. The surgical penile removal of the primary tumour remains standard of care. There was no difference in survival for age group

[Penile cancer in Mexico: Twenty years experience at a tertiary academic hospital.] / Cáncer de pene en México: 20 años de experiencia en un hospital académico de tercer nivel.

OBJECTIVE: The aim of this study was to report clinical features and management of penile cancer (CP) at the National Cancer Institute (INCan) of Mexico City over 20 years. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 405 cases of primary penile cancer (PC) treated at our institution between 1989 until 2015. Diagnosis, treatment and oncological outcomes are reported. RESULTS: Clinicopathologic and demographic information was available for 375 patients (mean age, 56 ys). At diagnosis, 140 (37.3 %) patients were cN0, 71(18.9%) cN1, 164 (43.37%) cN2 and 33 (8%) cN3. 14% had metastatic disease (lung and bone). Initial treatment included partial penectomy (n=123; 33.6%), and total penectomy (n=126;33.6%). 138 (36.2%) patients with high risk disease underwent bilateral inguinal lymph node dissection. 8% (56) had positive lymph nodes. Kaplan-Meier survival analysis showed a 10-year CSS (cancer specific survival) rate of 70%. There was no significant difference in CSS when stratifying per age. Five-year CSS for pT1, pT2, pT3 and T4 was 96%, 88%, 58% y T4 0%, respectively. A difference in CSS was found between pT2 and pT3 (p=0.047). CONCLUSION: The findings of our descriptive analysis provide information on natural history of penile cancer in Mexico. The surgical penile removal of the primary tumour remains standard of care. There was no difference in survival for age group.

OBJETIVO: Revisar las características clínicas y el manejo del cáncer de pene (CP) en el Instituto Nacional de Cancerología (INCan) de la Ciudad de México en 20 años de experiencia.MATERIAL Y MÉTODOS: Revisamos de forma retrospectiva a 405 pacientes con diagnóstico de CP tratados en INCan entre enero de 1989 hasta diciembre de 2015. Se describieron la modalidad de presentación de los casos, los resultados de patología, tratamiento y la sobrevida. RESULTADOS: Las informaciones clínico-patológicas y los resultados oncológicos fueron completas en 375 pacientes (edad media 56,82). Al diagnóstico 140 casos (n.37,3%) fueron cN0, 71 casos (18,9%) cN1, 164 casos (43,37%) cN2, 33 casos (8%) cN3. El 14% tuvieron metástasis a distancia (pulmón, huesos). El tratamiento inicial incluyó falectomía parcial (n=123; 33,6% y falectomía total (n=126; 33,6%). De 138 (36,2%) pacientes de alto riesgo sometidos a disección de ganglios linfáticos inguinales bilaterales, solo el 8% (n.56) tenían ganglios linfáticos positivos. El análisis de supervivencia de Kaplan-Meier mostró una tasa de SCE (sobrevida cáncer específica) a 10 años del 70%. No hubo diferencias significativas en la supervivencia para el grupo de edad. La CSS a 5 años para pT1, pT2, pT3 y T4 fue del 96%, 88%, 58% y 0%, respectivamente. Se encontró diferencia en la supervivencia entre pT2 y pT3 (p 0,047).CONCLUSIÓN: Los hallazgos de nuestra casuística proporcionan información sobre la historia natural del cáncer de pene en México. La amputación quirúrgica del tumor primario sigue siendo el patrón uro-oncológico para el tratamiento definitivo del CP. No hubo diferencias en la supervivencia para el grupo de edad.

Head to head comparison performance of 99mTc-EDDA/HYNIC-iPSMA SPECT/CT and 68Ga-PSMA-11 PET/CT a prospective study in biochemical recurrence prostate cancer patients.

Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) has found widespread use for the diagnosis of biochemical recurrence of prostate cancer (PCa). Unfortunately, PET/CT is not as widely available; thus a PSMA-targeting compound for scintigraphy is of special interest. The aim of this study was to compare 99mTc-EDDA/HYNIC-iPSMA and 68Ga-PSMA-11 PET/CT qualitatively and semi-quantitatively. Twenty-three patients with metastatic PCa were underwent 99mTc-EDDA/HYNIC-iPSMA SPECT/CT followed by 68Ga-PSMA-11 PET/CT. Gleason score in all patients was obtained. Maximal standardized uptake value (SUVmax) and counts per organ, including the primary and metastatic tumor, were normalized and compared using Pearson's correlation test. Sites considered as positive have increased SUVmax and tumor-to-background ratio (TBR) in comparison with non-diseased organs/tissues (SUVmax =25.2±4.7, 18.4±1.6, 11.4±1.2 (P=0.037) from prostate, bone and lymph nodes versus TBR =35.9±45.2, 15.4±18.9, 19.1±51.7 (P=0.035) for prostate, bone and lymph nodes. 99mTc-HYNIC-iPSMA and 68Ga-PSMA-11 uptake values in the evaluation of the affected nodes were very similar, although their ranges ranged from 5-21 mm (12±7.6). Correlation coefficient was normalized between SUVmax and TBR, demonstrating r values for prostate of r2=0.731; for bone of r2=0.720; and lymph nodes of r2=0.864 (P<0.05 in all cases). Values and confidence interval at the 95% are supporting the equivalency of both parameters in primary tumor and metastases (prostate 95% CI=4.61, 4.38; bone tissue 95% CI=-2.21, 3.41 and lymph node 95% CI=4.67). We conclude that 68Ga-PSMA-11 PET/CT and 99mTc-EDDA/HYNIC-iPSMA SPECT/CT were comparable, supporting the use of 99mTc-EDDA/HYNIC-iPSMA in patients with progressive metastatic castration-resistant PCa.

Renal Cell Carcinoma in a Pregnant Woman With Horseshoe Kidney.

To our knowledge, this is the first reported case of renal cell carcinoma in kidney horseshoe diagnosed in the second trimester of pregnancy. We performed open radical nephrectomy when the pregnancy was completed. Kidney cancer is rare during pregnancy and the symptoms can be mimic urinary infection. The diagnosis and its management can be a challenge.

Growing teratoma syndrome.

Growing teratoma syndrome (GTS) is a rare clinical entity, which presents with enlarging teratomas masses of the retroperitoneum or other locations, occurring during or after systemic chemotherapy for the treatment of nonseminomatous germ cell of the testis (NSGCT), with normalised tumour markers. Awareness of this syndrome is necessary in order to prevent unnecessary chemotherapy and allow optimal management. Prognosis is excellent after the excision of these tumors, but surgery has to be as complete as possible. Surgical resection of bulky GTS lesions is technically challenging; intraoperative complications may occur; that is, why the treatment must not be delayed. Our experience in the surgical management of these lesions is reviewed in the following work.