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Squamous Cell Carcinoma of the Penis and Scrotum

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Rare Genitourinary Tumors
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Abstract

Squamous cell carcinoma is the most common malignant tumor of the penis and scrotum. The risk of these rare tumors has been linked to lack of circumcision for penile cancer, occupational exposure to carcinogens for scrotal cancer, and exposure to human papillomavirus for both. Although there have been no randomized controlled trials, several treatment strategies have emerged consisting of surgery, radiotherapy, chemotherapy for advanced disease, and multimodal therapy for locally advanced disease. More effective treatment for metastatic squamous cell carcinoma of the penis or scrotum is urgently needed.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5–29.

    Article  PubMed  Google Scholar 

  2. Vyas R, et al. Squamous cell carcinoma of the scrotum: a look beyond the chimneystacks. World J Clin Cases. 2014;2(11):654–60.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Christodoulidou M, et al. Epidemiology of penile cancer. Curr Probl Cancer. 2015;39(3):126–36.

    Article  PubMed  Google Scholar 

  4. Dillner J, et al. Etiology of squamous cell carcinoma of the penis. Scand J Urol Nephrol. Supplementum. 2000;205:189–93.

    Google Scholar 

  5. Licklider S. Jewish penile carcinoma. J Urol. 1961;86:98.

    CAS  PubMed  Google Scholar 

  6. Favorito LA, et al. Epidemiologic study on penile cancer in Brazil. Int Braz J Urol: Off J Braz Soc Urol. 2008;34(5):587–91. discussion 591–3.

    Article  Google Scholar 

  7. Chaux A, Cubilla AL. Advances in the pathology of penile carcinomas. Hum Pathol. 2012;43(6):771–89.

    Article  CAS  PubMed  Google Scholar 

  8. Stern RS. Genital tumors among men with psoriasis exposed to psoralens and ultraviolet A radiation (PUVA) and ultraviolet B radiation. The photochemotherapy follow-up study. N Engl J Med. 1990;322(16):1093–7.

    Article  CAS  PubMed  Google Scholar 

  9. Djajadiningrat RS, et al. Human papillomavirus prevalence in invasive penile cancer and association with clinical outcome. J Urol. 2015;193(2):526–31.

    Article  PubMed  Google Scholar 

  10. de Sousa ID, et al. Prevalence of human papillomavirus in penile malignant tumors: viral genotyping and clinical aspects. BMC Urol. 2015;15:13.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chaux A, Cubilla AL. The role of human papillomavirus infection in the pathogenesis of penile squamous cell carcinomas. Semin Diagn Pathol. 2012;29(2):67–71.

    Article  PubMed  Google Scholar 

  12. Chaux A, et al. Combining routine morphology, p16(INK4a) immunohistochemistry, and in situ hybridization for the detection of human papillomavirus infection in penile carcinomas: a tissue microarray study using classifier performance analyses. Urol Oncol. 2014;32(2):171–7.

    Article  CAS  PubMed  Google Scholar 

  13. Rocha RM, et al. A clinical, pathologic, and molecular study of p53 and murine double minute 2 in penile carcinogenesis and its relation to prognosis. Hum Pathol. 2012;43(4):481–8.

    Article  CAS  PubMed  Google Scholar 

  14. Lopes A, et al. p53 as a new prognostic factor for lymph node metastasis in penile carcinoma: analysis of 82 patients treated with amputation and bilateral lymphadenectomy. J Urol. 2002;168(1):81–6.

    Article  PubMed  Google Scholar 

  15. Mannweiler S, et al. Two major pathways of penile carcinogenesis: HPV-induced penile cancers overexpress p16ink4a, HPV-negative cancers associated with dermatoses express p53, but lack p16ink4a overexpression. J Am Acad Dermatol. 2013;69(1):73–81.

    Article  CAS  PubMed  Google Scholar 

  16. Dillon MT, Harrington KJ. Human papillomavirus-negative pharyngeal cancer. J Clin Oncol: Off J Am Soc Clin Oncol. 2015;33(29):3251–61.

    Article  CAS  Google Scholar 

  17. Gunia S, et al. p16(INK4a) is a marker of good prognosis for primary invasive penile squamous cell carcinoma: a multi-institutional study. J Urol. 2012;187(3):899–907.

    Article  CAS  PubMed  Google Scholar 

  18. Hakenberg OW, et al. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015;67(1):142–50.

    Article  PubMed  Google Scholar 

  19. Cubilla AL. The role of pathologic prognostic factors in squamous cell carcinoma of the penis. World J Urol. 2009;27(2):169–77.

    Article  PubMed  Google Scholar 

  20. Edge S, Byrd D, Compton C. Penis. In: AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010.

    Google Scholar 

  21. Leijte JA, et al. Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a two-centre analysis of 700 patients. Eur Urol. 2008;54(1):161–8.

    Article  PubMed  Google Scholar 

  22. Alkatout I, et al. Squamous cell carcinoma of the penis: predicting nodal metastases by histologic grade, pattern of invasion and clinical examination. Urol Oncol. 2011;29(6):774–81.

    Article  PubMed  Google Scholar 

  23. Lont AP, et al. A comparison of physical examination and imaging in determining the extent of primary penile carcinoma. BJU Int. 2003;91(6):493–5.

    Article  CAS  PubMed  Google Scholar 

  24. Alnajjar HM, et al. Treatment of carcinoma in situ of the glans penis with topical chemotherapy agents. Eur Urol. 2012;62(5):923–8.

    Article  CAS  PubMed  Google Scholar 

  25. Meijer RP, et al. Long-term follow-up after laser therapy for penile carcinoma. Urology. 2007;69(4):759–62.

    Article  PubMed  Google Scholar 

  26. Shabbir M, et al. Glans resurfacing for the treatment of carcinoma in situ of the penis: surgical technique and outcomes. Eur Urol. 2011;59(1):142–7.

    Article  PubMed  Google Scholar 

  27. Li J, et al. Organ-sparing surgery for penile cancer: complications and outcomes. Urology. 2011;78(5):1121–4.

    Article  PubMed  Google Scholar 

  28. de Crevoisier R, et al. Long-term results of brachytherapy for carcinoma of the penis confined to the glans (N- or NX). Int J Radiat Oncol Biol Phys. 2009;74(4):1150–6.

    Article  PubMed  Google Scholar 

  29. Crook J, Jezioranski J, Cygler JE. Penile brachytherapy: technical aspects and postimplant issues. Brachytherapy. 2010;9(2):151–8.

    Article  PubMed  Google Scholar 

  30. Pagliaro LC, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol: Off J Am Soc Clin Oncol. 2010;28(24):3851–7.

    Article  CAS  Google Scholar 

  31. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Penile cancer, version 1.2016; http: NCCN.org, accessed March 22, 2016.

    Google Scholar 

  32. Zhu Y, et al. New N staging system of penile cancer provides a better reflection of prognosis. J Urol. 2011;186(2):518–23.

    Article  PubMed  Google Scholar 

  33. Bermejo C, et al. Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol. 2007;177(4):1335–8.

    Article  PubMed  Google Scholar 

  34. Djajadiningrat RS, et al. Neoadjuvant taxane-based combination chemotherapy in patients with advanced penile cancer. Clin Genitourin Cancer. 2015;13(1):44–9.

    Article  PubMed  Google Scholar 

  35. Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol. 1988;27(6b):823–4.

    Article  CAS  PubMed  Google Scholar 

  36. Leijte JA, et al. Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol. 2007;52(2):488–94.

    Article  CAS  PubMed  Google Scholar 

  37. Graafland NM, et al. Inguinal recurrence following therapeutic lymphadenectomy for node positive penile carcinoma: outcome and implications for management. J Urol. 2011;185(3):888–93.

    Article  PubMed  Google Scholar 

  38. Dickstein RJ, et al. Prognostic factors influencing survival from regionally advanced squamous cell carcinoma of the penis after preoperative chemotherapy. BJU Int. 2016;117(1):118–25.

    Article  CAS  PubMed  Google Scholar 

  39. Sharma P, et al. Adjuvant chemotherapy is associated with improved overall survival in pelvic node-positive penile cancer after lymph node dissection: a multi-institutional study. Urol Oncol. 2015;33(11)):496 e17–23.

    Article  PubMed  Google Scholar 

  40. Burt LM, Shrieve DC, Tward JD. Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys. 2014;88(1):94–100.

    Article  PubMed  Google Scholar 

  41. Kunos C, et al. Radiation therapy compared with pelvic node resection for node-positive vulvar cancer: a randomized controlled trial. Obstet Gynecol. 2009;114(3):537–46.

    Article  PubMed  Google Scholar 

  42. Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009;27(2):221–5.

    Article  CAS  PubMed  Google Scholar 

  43. Pond GR, et al. Concurrent chemoradiotherapy for men with locally advanced penile squamous cell carcinoma. Clin Genitourin Cancer. 2014;12(6):440–6.

    Article  PubMed  Google Scholar 

  44. Di Lorenzo G, et al. Cisplatin and 5-fluorouracil in inoperable, stage IV squamous cell carcinoma of the penis. BJU Int. 2012;110(11 Pt B):E661–6.

    Article  PubMed  Google Scholar 

  45. Haas GP, et al. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol. 1999;161(6):1823–5.

    Article  CAS  PubMed  Google Scholar 

  46. Theodore C, et al. A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol: Off J Eur Soc Med Oncol/ESMO. 2008;19(7):1304–7.

    Article  CAS  Google Scholar 

  47. Nicholson S, et al. Phase II trial of docetaxel, cisplatin and 5FU chemotherapy in locally advanced and metastatic penis cancer (CRUK/09/001). Br J Cancer. 2013;109(10):2554–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Zhang S, Zhu Y, Ye D. Phase II study of docetaxel, cisplatin, and fluorouracil in patients with distantly metastatic penile cancer as first-line chemotherapy. Oncotarget. 2015;6(31):32212–9.

    PubMed  PubMed Central  Google Scholar 

  49. Houédé N, et al. Intermediate analysis of a phase II trial assessing gemcitabine and cisplatin in locoregional or metastatic penile squamous cell carcinoma. BJU Int. 2016;117:444–9.

    Google Scholar 

  50. Di Lorenzo G, et al. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011;60(6):1280–4.

    Article  PubMed  Google Scholar 

  51. Wang J, Pettaway CA, Pagliaro LC. Treatment for metastatic penile cancer after first-line chemotherapy failure: analysis of response and survival outcomes. Urology. 2015;85(5):1104–10.

    Article  CAS  PubMed  Google Scholar 

  52. Rescigno P, et al. Combination of docetaxel and cetuximab for penile cancer: a case report and literature review. Anti-Cancer Drugs. 2012;23(5):573–7.

    Article  CAS  PubMed  Google Scholar 

  53. Brown A, et al. Epidermal growth factor receptor-targeted therapy in squamous cell carcinoma of the penis: a report of 3 cases. Urology. 2014;83(1):159–65.

    Article  PubMed  Google Scholar 

  54. Carthon BC, et al. Epidermal growth factor receptor-targeted therapy in locally advanced or metastatic squamous cell carcinoma of the penis. BJU Int. 2014;113(6):871–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Necchi A, et al. Proof of activity of anti-epidermal growth factor receptor-targeted therapy for relapsed squamous cell carcinoma of the penis. J Clin Oncol: Off J Am Soc Clin Oncol. 2011;29(22):e650–2.

    Article  Google Scholar 

  56. Necchi, A, et al. Panitumumab Treatment for Advanced Penile Squamous Cell Carcinoma When Surgery and Chemotherapy Have Failed. Clin Genitourin Cancer. 2015; online ahead of print.

    Google Scholar 

  57. Men HT, et al. A case of penile squamous cell carcinoma treated with a combination of antiepidermal growth factor receptor antibody and chemotherapy. Anti-Cancer Drugs. 2014;25(1):123–5.

    Article  CAS  PubMed  Google Scholar 

  58. Chaux A, et al. The epidermal growth factor receptor is frequently overexpressed in penile squamous cell carcinomas: a tissue microarray and digital image analysis study of 112 cases. Hum Pathol. 2013;44(12):2690–5.

    Article  CAS  PubMed  Google Scholar 

  59. Wang J, et al. Programmed death ligand-1 (PD-L1) expression in penile squamous cell carcinoma (meeting abstract). J Clin Oncol. 2015;33(suppl 7):abstr 393.

    Google Scholar 

  60. Sharma P, Allison JP. The future of immune checkpoint therapy. Science. 2015;348(6230):56–61.

    Article  CAS  PubMed  Google Scholar 

  61. Starr P. Encouraging results for pembrolizumab in head and neck cancer. Am Health Drug Benefits. 2015;8(Spec Issue):16.

    PubMed  PubMed Central  Google Scholar 

  62. Flaherty A, et al. Implications for human papillomavirus in penile cancer. Urol Oncol. 2014;32(1):53 e1–8.

    Article  PubMed  Google Scholar 

  63. Barber J. The development of a clinical trial protocol to test the timing and effectiveness of adjuvant and neoadjuvant therapy in locally advanced penile cancer. Curr Probl Cancer. 2015;39(3):173–85.

    Article  PubMed  Google Scholar 

  64. Boffetta P, Jourenkova N, Gustavsson P. Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons. Cancer Causes Control: CCC. 1997;8(3):444–72.

    Article  CAS  PubMed  Google Scholar 

  65. Roush GC, Schymura MJ, Flannery JT. Secular and age distribution of scrotal cancer in Connecticut and a review of United States literature. Cancer. 1984;54(3):596–601.

    Article  CAS  PubMed  Google Scholar 

  66. Taniguchi S, et al. Squamous cell carcinoma of the scrotum. Dermatology. 1996;193(3):253–4.

    Article  CAS  PubMed  Google Scholar 

  67. Matoso A, et al. Squamous neoplasia of the scrotum: a series of 29 cases. Am J Surg Pathol. 2014;38(7):973–81.

    Article  PubMed  Google Scholar 

  68. Andrews PE, Farrow GM, Oesterling JE. Squamous cell carcinoma of the scrotum: long-term followup of 14 patients. J Urol. 1991;146(5):1299–304.

    CAS  PubMed  Google Scholar 

  69. McDonald MW. Carcinoma of scrotum. Urology. 1982;19(3):269–74.

    Article  CAS  PubMed  Google Scholar 

  70. Huen KH, et al. Scrotal abscess as initial presentation of squamous cell carcinoma. Case Rep Urol. 2013;2013:807346.

    PubMed  PubMed Central  Google Scholar 

  71. Verhoeven RH, et al. Scrotal cancer: incidence, survival and second primary tumours in the Netherlands since 1989. Br J Cancer. 2010;103(9):1462–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Oluwasanmi JO, Williams AO, Alli AF. Superficial cancer in Nigeria. Br J Cancer. 1969;23(4):714–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Criton S, Aravindan KP. Bowenoid papulosis turning to squamous cell carcinoma. Indian J Dermatol Venereol Leprol. 1998;64(1):37–9.

    CAS  PubMed  Google Scholar 

  74. Lowe FC. Squamous cell carcinoma of the scrotum. J Urol. 1983;130(3):423–7.

    CAS  PubMed  Google Scholar 

  75. Rosevear HM, et al. Utility of (1)(8)F-FDG PET/CT in identifying penile squamous cell carcinoma metastatic lymph nodes. Urol Oncol. 2012;30(5):723–6.

    Article  PubMed  Google Scholar 

  76. Azike JE. A review of the history, epidemiology and treatment of squamous cell carcinoma of the scrotum. Rare Tumors. 2009;1(1):e17.

    Article  PubMed  PubMed Central  Google Scholar 

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Pagliaro, L. (2016). Squamous Cell Carcinoma of the Penis and Scrotum. In: Pagliaro, L. (eds) Rare Genitourinary Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-30046-7_19

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  • DOI: https://doi.org/10.1007/978-3-319-30046-7_19

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