137 results on '"Nick Watkin"'
Search Results
2. Update on penile sparing surgery for penile cancer
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B. Ayres, Eleni Anastasiadis, and Nick Watkin
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Male ,Surgical resection ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Standard of care ,business.industry ,Urology ,Outcome measures ,medicine.disease ,Surgery ,Distress ,medicine.anatomical_structure ,medicine ,Humans ,Penile cancer ,Neoplasm Recurrence, Local ,business ,Sexual function ,Organ Sparing Treatments ,Penile Neoplasms ,Penis - Abstract
PURPOSE OF REVIEW Penile sparing surgery (PSS) is considered the standard of care in penile cancer where appropriate, as preservation of the penis may enable the patient to maintain urinary and sexual function. This review will focus on the latest developments over the past two years. RECENT FINDINGS In this review, we discuss the latest findings in oncological outcomes in PSS, specifically glansectomy. We also introduce technology that may be useful in improving the precision of surgical resection margins in PSS. Finally, we consider the value of patient-reported outcome measures (PROMs) and consider how research in this area can be improved. SUMMARY A recent study has found a correlation between local recurrences (LR) and worse overall and cancer-specific survival in glansectomy, which challenges the belief that LR do not confer worse oncological outcomes. Despite numerous studies evaluating PROMs in penile cancer/PSS, few of these studies provide quality evidence of the 'supportive care needs'. A shift in research is required to identify those men at most risk of distress and to identify ways to support men diagnosed with penile cancer.
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- 2021
3. Endoscopic urethrotomy versus open urethroplasty for men with bulbar urethral stricture: the OPEN randomised trial cost-effectiveness analysis
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Jing Shen, Luke Vale, Beatriz Goulao, Paul Whybrow, Stephen Payne, Nick Watkin, and OPEN trial investigators
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Male ,medicine.medical_specialty ,Urethroplasty ,Urologic Surgical Procedures, Male ,Urethrotomy ,Urethral stricture ,Cost effectiveness ,Cost-Benefit Analysis ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Superiority Trial ,Urethra ,Randomized controlled trial ,Recurrence ,law ,medicine ,Humans ,Economic model ,Randomised controlled trial ,business.industry ,Research ,030503 health policy & services ,Endoscopy ,General Medicine ,Cost-effectiveness analysis ,medicine.disease ,Diseases of the genitourinary system. Urology ,Surgery ,Reproductive Medicine ,Cost-effectiveness ,RC870-923 ,0305 other medical science ,business ,Bulbar urethral stricture - Abstract
Background Bulbar urethral stricture is a common cause for urinary symptoms in men and its two main treatment options both have drawbacks with little evidence on their relative cost-effectiveness. Current guidelines on the management of recurrent bulbar urethral stricture have been predominantly based on expert opinion and panel consensus. Objective To assess the relative cost-effectiveness of open urethroplasty and endoscopic urethrotomy as treatment for recurrent urethral stricture in men. Methods Set in the UK National Health Service with recruitment from 38 hospital sites, a randomised controlled trial of open urethroplasty and endoscopic urethrotomy with 6-monthly follow-up over 24 months was conducted. Two hundred and twenty-two men requiring operative treatment for recurrence of bulbar urethral stricture and having had at least one previous intervention for stricture were recruited. Effectiveness was measured by quality- adjusted life years (QALYs) derived from EQ-5D 5L. Cost-effectiveness was measured by the incremental cost per QALY gained over 24 months using a within trial analysis and a Markov model with a 10-year time horizon. Results In the within trial, urethroplasty cost on average more than urethrotomy (cost difference: £2148 [95% CI 689, 3606]) and resulted in a similar number of QALYs on average (QALY difference: − 0.01 [95% CI − 0.17, 0.14)] over 24 months. The Markov model produced similar results. Sensitivity analyses using multiple imputation, suggested that the results were robust, despite observed missing data. Conclusions Based on current practice and evidence, urethrotomy is a cost-effective treatment compared with urethroplasty. Keypoints Urethrotomy and urethroplasty both led to symptom improvement for men with bulbar urethral stricture—a common cause for urinary symptoms in men; Urethroplasty appeared unlikely to offer good value for money compared to urethrotomy based on current evidence. Trial registration: ISRCTN: 98009168 (date: 29 November 2012) and it is also in the UK NIHR Portfolio (reference 13507). Trial protocol: The latest version (1.8) of the full protocol is available at: www.journalslibrary.nihr.ac.uk/programmes/hta/105723/#/ and a published version is also available: Stephenson R, Carnell S, Johnson N, Brown R, Wilkinson J, Mundy A, et al. Open urethroplasty versus endoscopic urethrotomy—clarifying the management of men with recurrent urethral stricture (the OPEN trial): study protocol for a randomised controlled trial. Trials 2015;16:600. https://doi.org/10.1186/s13063-015-1120-4. Trial main clinical results publication: Goulao B, Carnell S, Shen J, MacLennan G, Norrie J, Cook J, et al. Surgical Treatment for Recurrent Bulbar Urethral Stricture: A Randomised Open-label Superiority Trial of Open Urethroplasty Versus Endoscopic Urethrotomy (the OPEN Trial), European Urology, Volume 78, Issue 4, 2020, Pages 572–580.
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- 2021
4. PD51-11 CONCOMITANT VS STAGED LYMPHADENECTOMY IN CLINICALLY NODE-POSITIVE PENILE SQUAMOUS CELL CARCINOMA: RECURRENCE PATTERNS AND SURVIVAL OUTCOMES
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Heather Huelster, Marco Bandini, Oscar Brouwer, Maarten Albersen, Eduard Roussel, Hielke de Vries, Juan Chipollini, Mounsif Azizi, Yao Zhu, Ding-Wei Ye, Antonio Ornellas, Mario Catanzaro, Laura Marandino, Oliver Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Mohamed Ahmed, Jeffrey Karnes, Alberto Briganti, Roberto Salvioni, Francesco Montorsi, Andrea Necchi, and Philippe Spiess
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Urology - Published
- 2022
5. Practice Patterns Among Penile Cancer Surgeons Performing Dynamic Sentinel Lymph Node Biopsy and Radical Inguinal Lymph Node Dissection in Men with Penile Cancer: A eUROGEN Survey
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Nick Watkin, Maarten Albersen, Benjamin E. Ayres, Arie Parnham, Asif Muneer, Allaudin Issa, Vijay K Sangar, and Christian D. Fankhauser
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medicine.medical_specialty ,CARCINOMA ,Urology ,Sentinel lymph node ,lcsh:RC870-923 ,lcsh:RC254-282 ,Biopsy ,Brief Correspondence ,medicine ,Penile cancer ,Sampling (medicine) ,COMPLICATIONS ,Science & Technology ,medicine.diagnostic_test ,business.industry ,General surgery ,Perioperative ,Urology & Nephrology ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,LYMPHADENECTOMY ,Dissection ,Lymphatic system ,Incision Site ,Inguinal lymph node dissection ,business ,Life Sciences & Biomedicine ,Dynamic sentinel node biopsy - Abstract
UNLABELLED: Dynamic sentinel lymph node biopsy (DSNB) and radical inguinal lymph node dissection (ILND) are important in the management of penile cancer patients, but high-level evidence for preoperative, perioperative, and postoperative management remains scarce. According to an online survey of 35 surgeons from ten European countries, 57% perform >10 ILND procedures per year and 86% offer DSNB. Furthermore, management differs substantially for dye injection site, use of lymphoscintigraphy, preferred incision sites, techniques for lymphatic control, duration of empiric antibiotic therapy, perioperative thromboprophylaxis, time points for drain removal, and definition of the ILND dissection floor. Consensus was observed for the use of perioperative antibiotics (although not duration and type) and the borders for ILND template definitions. We conclude that there is significant variation in patient management among eUROGEN penile cancer surgeons. This heterogeneity may confound multicentre studies; therefore, a consensus to standardise inguinal node management in penile cancer across European penile cancer centres is warranted. PATIENT SUMMARY: Our survey reveals that preferences and surgical techniques for inguinal lymph node sampling and removal varies significantly between European penile cancer surgeons. Consensus is needed to standardise the management approach for penile cancer. ispartof: EUROPEAN UROLOGY OPEN SCIENCE vol:24 pages:39-42 ispartof: location:Netherlands status: published
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- 2021
6. Long‐term multicentre experience of adjuvant radiotherapy for pN3 squamous cell carcinoma of the penis
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B. Ayres, Lona Vyas, Vincent Khoo, Ann Henry, Alison Tree, Michael Ager, Lisa Pickering, Ian Eardley, Angus Robinson, Kelechi Njoku, Nick Watkin, Mehran Afshar, Maria Serra, Mamoun Elmamoun, and Oliver Kayes
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Male ,medicine.medical_specialty ,Time Factors ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,medicine ,Adjuvant therapy ,Humans ,Penile Neoplasms ,Lymph node ,Aged ,Neoplasm Staging ,Retrospective Studies ,Chemotherapy ,business.industry ,Middle Aged ,Surgery ,Radiation therapy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Cohort ,Carcinoma, Squamous Cell ,Radiotherapy, Adjuvant ,business ,Adjuvant ,Penis - Abstract
Objective To present the long‐term adjuvant radiotherapy outcomes of patients with pN3 squamous cell carcinoma of the penis (SCCp) treated at two UK centres. Patients and Methods We conducted a retrospective audit of all pN3 SCCp patients, deemed suitable for adjuvant therapy by a specialist multidisciplinary team at St George’s and Leeds Hospitals, who received adjuvant radiotherapy. Primary outcomes were recurrence‐free survival (RFS), cancer‐specific survival (CSS) and overall survival (OS). Secondary outcomes were time to adjuvant treatment, frequency of in‐field recurrence, site and side of recurrence, and dose and schedule of radiotherapy. Results A total of 146 patients were included: 121 completed radiotherapy, four did not complete radiotherapy and 21 did not start it. The median (interquartile range [IQR]) age was 59 (54–70)years. The 5‐year RFS was 51%, CSS was 51% and OS was 44%. Adjuvant radiotherapy was started at a median (IQR) of 75 (48–106) days. A dose of 45 Gy in 20 fractions was most commonly used. Of the 125 patients who started adjuvant treatment, 55 relapsed. Of these relapses, 30 occurred in an inguinal or pelvic nodal station and 26 of the 30 were in a radiation field. Relapses in 18 of the 55 cases were in visceral sites only and seven were in both nodal (non‐irradiated sites) and visceral sites. Doses of 50 Gy) were more commonly used after 2013. Conclusions Application of a standard radiotherapy protocol within a centralized supra‐network setting has achieved survival outcomes that would appear better than those previously documented for either radiotherapy or chemotherapy in a cohort with solely pN3 disease. The addition of adjuvant chemotherapy may improve these outcomes further. These data suggest that adjuvant radiotherapy has a role to play in the management of men with pN3 SCCp.
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- 2020
7. A risk calculator predicting recurrence in lymph node metastatic penile cancer
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Oliver W. Hakenberg, Yao Zhu, Alberto Briganti, Filippo Pederzoli, Dingwei Ye, Hielke M. de Vries, Axel Heidenreich, Mohamed E. Ahmed, Maarten Albersen, Juan Chipollini, Roberto Salvioni, Mario Catanzaro, Antonio Augusto Ornellas, Laura Marandino, Jeffrey Karnes, Philippe E. Spiess, Eduard Roussel, Andrea Necchi, Francesco Montorsi, Oscar R. Brouwer, Nick Watkin, Marco Bandini, Mounsif Azizi, Friederike Haidl, and Michael Ager
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Oncology ,medicine.medical_specialty ,Referral ,Proportional hazards model ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Internal medicine ,Cohort ,medicine ,Penile cancer ,Radiation treatment planning ,business ,Lymph node ,Adjuvant ,Metastatic Penile Cancer - Abstract
Objectives To develop and externally validate a risk calculator for prediction of any cancer recurrence in patients with penile squamous cell carcinoma (pSCC) and inguinal lymph node metastases (ILNM), as to date no validated prognostic tool is available for patients with pSCC and ILNM. Patients and methods The development cohort included 234 patients from seven referral centres. The external validation cohort included 273 patients from two additional referral centres. Cox regression identified predictors of any recurrence, which were used to develop a risk calculator. The risk-calculator grouped the development and the validation cohorts according to the individual risk of any recurrence at 24 months (24m-R). Adjuvant treatment effects were tested on overall survival (OS) according to the derived tertiles, within the development and validation cohorts. Results Positive surgical margins, pN3 , and ILNM ratio were associated with higher recurrence rate. The 2-year OS rates were lower for patients with high (>37%) and intermediate (19-37%) compared to low ( 0.1). Conclusion Adjuvant treatment planning is crucial in patients with pSCC with ILNM, where only weak evidence is available. The current tool proved to successfully stratify patients according to their individual risk, potentially allowing better tailoring of adjuvant treatments.
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- 2020
8. Red cell differential width (RDW) as a predictor of survival outcomes with palliative and adjuvant chemotherapy for metastatic penile cancer
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Wing K Liu, Alison Tree, Reena Patel, Nick Watkin, Benjamin Ayres, Mehran Afshar, Lisa Pickering, and Louise English
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Adult ,Erythrocyte Indices ,Male ,0301 basic medicine ,Nephrology ,Oncology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Renal cell carcinoma ,Internal medicine ,medicine ,Humans ,Penile cancer ,Survival outcomes ,Neoplasm Metastasis ,Correlation of Data ,Penile Neoplasms ,Aged ,Retrospective Studies ,Aged, 80 and over ,Chemotherapy ,Urology - Original Paper ,business.industry ,Palliative Care ,Hazard ratio ,Red blood cell distribution width ,Biomarker ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Log-rank test ,030104 developmental biology ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Cohort ,Red cell differential width ,business - Abstract
Purpose Red cell distribution width (RDW) measures red cells’ size variability. Metastatic penile cancer displays poor chemotherapy response. As no validated prognostic predictor exists, we investigated whether RDW correlates independently with survival outcomes in metastatic penile cancer treated by chemotherapy. Methods Electronic chemotherapy files of patients with metastatic penile cancer (M1 or N3) from a large academic supra-regional centre were retrospectively analysed between 2005 and 2018. Patients were stratified into RDW > 13.9% and Results 58 patients were analysed. The RDW-high group (n = 31) had a poorer survival than the RDW-low group (n = 27). Median overall survival (mOS) in all patients was 19.0 months (95% CI 13.1–24.9). mOS for RDW-high was 15.0 months (95% CI 10.1–19.9) and 37.0 months (95% CI 32.3–43.1) for RDW-low. Kaplan–Meier curves showed a clear disparity in survival (log rank p = 0.025). Cox proportional hazard ratio for death, corrected for T-stage, grade, age and deprivation score was 0.43 (p = 0.04). Sub-analysis of the M1 patients showed mOS in RDW-high of 17 m (95% CI 11.6–22.4) vs. NR; HR for death of 0.42. N3 patients’ mOS in RDW-high cohort was 30 months (95% CI 4.5–55.9) vs. 13 months (95% CI 1.8–24.2) in RDW-low; HR for death was 0.30. Conclusion RDW correlates independently with survival outcomes in metastatic penile cancer and may act as a potential predictor of survival outcomes for patients with metastatic penile cancer receiving chemotherapy.
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- 2020
9. Optimising the selection of candidates for neoadjuvant chemotherapy amongst patients with node-positive penile squamous cell carcinoma
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Maarten Albersen, Andrea Necchi, Alberto Briganti, Filippo Pederzoli, Marco Bandini, Francesco Montorsi, Nick Watkin, Friederike Haidl, Mario Catanzaro, Elio Mazzone, Daniele Raggi, Antonio Augusto Ornellas, Mounsif Azizi, Laura Marandino, Philippe E. Spiess, Michael Ager, Axel Heidenreich, Oliver W. Hakenberg, Juan Chipollini, Yao Zhu, and Dingwei Ye
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Fluorodeoxyglucose ,medicine.medical_specialty ,Chemotherapy ,business.industry ,Urology ,medicine.medical_treatment ,Hazard ratio ,030232 urology & nephrology ,Area under the curve ,Inguinal lymphadenopathy ,medicine.disease ,Confidence interval ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine ,Penile cancer ,Radiology ,medicine.symptom ,business ,Lymph node ,medicine.drug - Abstract
Objectives To identify predictors of poor overall survival (OS) amongst patients with penile squamous cell carcinoma (pSCC) with clinical inguinal lymphadenopathy (cN+), in order to define the best candidates for neoadjuvant chemotherapy (NAC). Patients and methods Using an international, multicentre database of 924 patients with pSCC, we identified 334 men who harboured cN+ with available clinical and follow-up data. Lymph node involvement was defined either by the presence of palpable inguinal node disease or by preoperative computed tomography (CT) assessment. Fluorine-18 fluorodeoxyglucose positron-emission tomography (18 F-FDG-PET)/CT scan was performed based on clinical judgment of the treating physician. Regression-tree analysis generated a risk stratification tool for prediction of 24-month overall mortality (OM). Kaplan-Meier explored the OS benefit related to the use of NAC according to the regression-tree-stratified subgroups. Results Overall, 120 (35.9%), 152 (45.5%), and 62 (18.6%) patients harboured cN1, cN2, and cN3 disease. 18 F-FDG-PET/CT was performed in 48 (14.4%) patients, and 16 (4.8%) had inguinal and pelvic nodal PET detection. The median OS was 107 months, with a 24-month OS of 66%. At regression-tree analysis (area under the curve = 70%), patients with cN3 and cN2 with PET/CT-detected inguinal and pelvic nodal activity had a higher risk of 24-month OM (>50%). NAC was associated with improved 24-month OS rates (54% vs 33%) only in this subgroup of patients (P = 0.002), which was also confirmed after multivariable adjustment (hazard ratio 0.28, 95% confidence interval 0.13-0.62; P = 0.002). Conclusion Patients with pSCC with cN3 or cN2 and inguinal and pelvic 18F-FDG-PET/CT scan detected disease had higher 24-month OM rates according to our regression-tree model. NAC was associated with improved OS only in these subgroups of patients. Our novel decision model may help to stratify cN+ patients, and identify those who most likely will benefit from NAC prior to radical surgical resection.
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- 2020
10. Testicular rupture: Simplifying the diagnosis
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Jai Seth, Davendra Sharma, Michael Gonsalves, Nick Watkin, and Lap Yan Leung
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medicine.medical_specialty ,business.industry ,Urology ,030232 urology & nephrology ,Testicular rupture ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Ultrasound imaging ,Medicine ,Surgery ,Radiology ,business - Abstract
Objective: To review the use of ultrasound imaging in the diagnosis of testicular rupture and in relation to current guidelines. Methods: Data was retrospectively collected for all patients diagnosed with testicular rupture at a major trauma centre between 2011 and 2018. Data included patient demographics, mechanism of trauma, specific findings on ultrasound and outcomes. On review of ultrasound imaging, specific findings identified include a breach in the tunica albuginea (currently advised in guidelines), heterogenicity and contour loss. Results: Eight patients were identified with average age 37 years old, mechanism of trauma was 50%, 37.5% and 12.5% for motorcycle road traffic collision, sporting injury and workplace injury respectively. A breach of tunica albuginea was identified on ultrasound in 65% of cases, compared with 100% of cases showing contour loss and heterogenicity. Of the 87.5% patients who were managed surgically one needed orchidectomy (and later testosterone replacement). Conclusion: Guidelines have varied on how to use ultrasound imaging in diagnosing a clinically difficult condition. Our case series demonstrates that diagnosing testicular rupture by looking for more easily identifiable characteristics (heterogenicity and contour loss) than currently recommended in the guidelines (breech in the tunica albuginea) will aid diagnosis and patient pathway and improve outcomes. Level of evidence: 5
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- 2019
11. PD53-10 PREDICTING LIMITED SURVIVAL FOR PATIENTS WITH PENILE CANCER UNDERGOING INGUINAL LYMPH NODE DISSECTION
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Maarten Albersen, Young-Chul Kim, Dingwei Ye, Mario Catanzaro, Antonio Augusto Ornellas, Alberto Briganti, Filippo Pederzoli, Oliver W. Hakenberg, Mahrukh Naqvi, Laura Marandino, Jeffrey Karnes, Mohamed E. Ahmed, Michael Ager, Nicholas H. Chakiryan, Eduard Roussel, Juan Chipollini, Axel Heidenreich, Lee A. Hugar, Nick Watkin, Roberto Salvioni, Yao Zhu, Friederike Haidl, Marco Bandini, Andrea Necchi, Francesco Montorsi, and Philippe E. Spiess
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medicine.medical_specialty ,Poor prognosis ,Palliative care ,Squamous cell cancer ,business.industry ,Urology ,Inguinal lymph nodes ,medicine.disease ,Surgery ,Dissection ,High morbidity ,Medicine ,Penile cancer ,business - Abstract
INTRODUCTION AND OBJECTIVE:Patients with advanced penile squamous cell cancer (pSCC) have a poor prognosis and undergo treatments with high morbidity. Palliative care alongside treatments with cura...
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- 2021
12. PD53-01 FACTORS ASSOCIATED WITH ADDITIONAL TUMOUR-BEARING LYMPH NODES AT COMPLETION ILND AFTER POSITIVE DSNB FOR PENILE CANCER STAGING: A EUROPEAN MULTICENTRE EVALUATION
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Marchel Stuiver, Bin K. Kroon, Vijay K Sangar, Hack Jae Lee, M. Albersen, B. Ayres, S. Horenblas, Arie Parnham, H.M. De Vries, Oscar R. Brouwer, Nick Watkin, I.J. De Jong, A. Muneer, and Eduard Roussel
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medicine.medical_specialty ,business.industry ,Urology ,medicine ,Penile cancer ,Lymph ,Radiology ,medicine.disease ,business - Published
- 2021
13. PD48-07 FINAL VALIDATION OF A PATIENT REPORTED OUTCOME MEASURE (PROM) FOR PENILE CURVATURE SURGERY
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Madhavi Natarajan, Pareeta Patel, Jade Harrison, Nick Watkin, Benjamin Ayres, Deji Akiboye, Marta Skrodzka, Eleni Anastasiadis, and Sylvia Yan
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medicine.medical_specialty ,business.industry ,Urology ,Measure (physics) ,medicine ,Patient-reported outcome ,Prom ,Penile curvature ,business ,Surgery - Published
- 2021
14. MP40-20 DO PATIENTS WITH PALPABLE (cN+) INGUINAL NODE INVOLVEMENT FOR pN1 or pN2 STAGING HAVE A WORSE PROGNOSIS THAN THOSE WITH cN0/pN+ DISEASE DETECTED ON SENTINEL NODE BIOPSY?
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Ben Ayres, Wayne Lam, Sylvia Yan, Hack Jae Lee, Nick Watkin, Marta Skrodzka, and Eleni Anastasiadis
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Node (networking) ,Biopsy ,medicine ,Radiology ,Disease ,Sentinel node ,business - Published
- 2021
15. Patterns of Recurrence following Inguinal Lymph Node Dissection for Penile Cancer: Optimizing Surveillance Strategies
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Dingwei Ye, Axel Heidenreich, Aaron Dahmen, Filippo Pederzoli, Alberto Briganti, Maarten Albersen, Mario Catanzaro, Roberto Salvioni, Antonio Augusto Ornellas, Philippe E. Spiess, Michael Ager, Laura Marandino, Nicholas H. Chakiryan, Friederike Haidl, Eduard Roussel, Marco Bandini, Jad Chahoud, Nick Watkin, Oliver W. Hakenberg, Yao Zhu, Andrea Necchi, Francesco Montorsi, Chakiryan, Nicholas H, Dahmen, Aaron, Bandini, Marco, Pederzoli, Filippo, Marandino, Laura, Albersen, Maarten, Roussel, Eduard, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A, Catanzaro, Mario, Hakenberg, Oliver W, Heidenreich, Axel, Haidl, Friederike, Watkin, Nick, Ager, Michael, Chahoud, Jad, Briganti, Alberto, Salvioni, Roberto, Montorsi, Francesco, Necchi, Andrea, and Spiess, Philippe E
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Male ,medicine.medical_specialty ,recurrence ,Penile squamous cell carcinoma ,Urology ,Inguinal lymph nodes ,Penile Neoplasm ,Inguinal Canal ,outcomes ,Disease-Free Survival ,Metastasis ,neoplasm metastasis ,penile neoplasms ,medicine ,metastasis ,Penile cancer ,Humans ,Penile Neoplasms ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Middle Aged ,penile cancer ,medicine.disease ,Dissection ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Radiology ,Lymph Nodes ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
PURPOSE: Our primary objective is to detail the incidence, site, and timing of penile squamous cell carcinoma (pSCC) recurrence after inguinal lymph node dissection (ILND). MATERIALS AND METHODS: We performed a retrospective analysis of 551 patients who underwent ILND for pSCC from 2000 to 2017. The primary outcome was pSCC recurrence after ILND. Recurrences were identified and stratified by site. Timing of recurrence was determined. Multivariable logistic regression analysis determined associations with recurrence. Multivariable Cox regression analysis determined associations with overall survival (OS). Sub-group analysis of the distant recurrences analyzed timing and OS by site of distant recurrence. RESULTS: After ILND pSCC recurred in 176 (31.9%) patients. Median time to recurrence was 10 months for distant recurrences, 12 for inguinal, 10.5 for pelvic, and 44.5 for local. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months of ILND, versus 127 months for local recurrences. Post-ILND recurrence was associated with pN2 (OR 1.99, 95% CI 1.0-4.1), and pN3 (OR 7.2, 95% CI 4.0-13.7). Patients who had local recurrence had similar OS to those without (HR 1.5, 95% CI 0.6-3.8), and worse OS was identified in patients with inguinal (HR 4.5, 95% CI 2.8-7.1), pelvic (HR 2.6, 95% CI 1.5-4.5), or distant (HR 4.0, 95% CI 2.7-5.8) recurrences. Patients with lung recurrences had worse OS than other sites (HR 2.2, 95% CI 1.1-4.3). CONCLUSIONS: Of the patients 31.9% had post-ILND recurrence associated with high pN staging. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months, suggesting surveillance beyond this is low yield. Local recurrences occurred over a longer timeline, emphasizing necessity of long-term surveillance of the primary site. ispartof: JOURNAL OF UROLOGY vol:206 issue:4 pages:960-968 ispartof: location:United States status: published
- Published
- 2021
16. A Systematic Review and Meta-analysis of Adjuncts to Minimally Invasive Treatment of Urethral Stricture in Men
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Christopher R. Chapple, Christopher Harding, Nick Watkin, Karl H. Pang, Robin Chatters, Alison P Downey, Daniel Hind, and Nadir I. Osman
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Male ,medicine.medical_specialty ,Triamcinolone acetonide ,Captopril ,Urethrotomy ,Urethral stricture ,Urology ,medicine.medical_treatment ,Mitomycin ,Context (language use) ,Injections, Intralesional ,Triamcinolone ,Urethra ,Recurrence ,medicine ,Humans ,Urethral Stricture ,business.industry ,Mitomycin C ,medicine.disease ,Surgery ,Catheter ,Tamoxifen ,medicine.anatomical_structure ,Meta-analysis ,business ,medicine.drug - Abstract
Urethral stricture disease (USD) is initially managed with minimally invasive techniques such as urethrotomy and urethral dilatation. Minimally invasive techniques are associated with a high recurrence rate, especially in recurrent USD. Adjunctive measures, such as local drug injection, have been used in an attempt to reduce recurrence rates.To systematically review evidence for the efficacy and safety of adjuncts used alongside minimally invasive treatment of USD.A systematic review of the literature published between 1990 and 2020 was conducted in accordance with the PRISMA checklist.A total of 26 studies were included in the systematic review, from which 13 different adjuncts were identified, including intralesional injection (triamcinolone, n = 135; prednisolone, n = 58; mitomycin C, n = 142; steroid-mitomycin C-hyaluronidase, n = 103, triamcinolone-mitomycin C-N-acetyl cysteine, n = 50; platelet-rich plasma, n = 44), intraluminal instillation (mitomycin C, n = 20; hyaluronic acid and carboxymethylcellulose, n = 70; captopril, n = 37; 192-iridium brachytherapy, n = 10), application via a lubricated catheter (triamcinolone, n = 124), application via a coated balloon (paclitaxel, n = 106), and enteral application (tamoxifen, n = 30; deflazacort, n = 36). Overall, 13 randomised controlled trials were included in the meta-analysis. Use of any adjunct was associated with a lower rate of USD recurrence (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.27-0.50; p 0.001) compared to no adjunct use. Of all the adjuncts, mitomycin C was associated with the lowest rate of USD recurrence (intralesional injection: OR 0.23, 95% CI 0.11-0.48; p 0.001; intraluminal injection: OR 0.11, 95% CI 0.02-0.61; p = 0.01). Urinary tract infection (2.9-14%), bleeding (8.8%), and extravasation (5.8%) were associated with steroid injection; pruritis of the urethra (61%) occurred after instillation of captopril; mild gynaecomastia (6.7%) and gastrointestinal side effects (6.7%) were associated with oral tamoxifen.Adjuncts to minimally invasive treatment of USD appear to lower the recurrence rate and are associated with a low adjunct-specific complication rate. However, the studies included were at high risk of bias. Mitomycin C is the adjunct supported by the highest level of evidence.We reviewed studies on additional therapies (called adjuncts) to minimally invasive treatments for narrowing of the urethra in men. Adjuncts such as mitomycin C injection result in a lower recurrence rate compared to no adjunct use. The use of adjuncts appeared to be safe and complications are uncommon; however, the studies were small and of low quality.
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- 2021
17. Clinicopathological predictors of finding additional inguinal lymph node metastases in penile cancer patients after positive dynamic sentinel node biopsy: a European multicentre evaluation
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Hielke M. de Vries, Hack Jae Lee, Wayne Lam, Rosa S. Djajadiningrat, Sarah R. Ottenhof, Eduard Roussel, Bin Klaas Kroon, Igle Jan de Jong, Pedro Oliveira, Hussain M. Alnajjar, Maarten Albersen, Asif Muneer, Vijay Sangar, Arie Parnham, Benjamin Ayres, Nick Watkin, Simon Horenblas, Martijn M. Stuiver, Oscar R. Brouwer, Rehabilitation medicine, AMS - Rehabilitation & Development, Amsterdam Movement Sciences - Rehabilitation & Development, Master Evidence Based Practice, APH - Health Behaviors & Chronic Diseases, and APH - Quality of Care
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Male ,Models, Statistical ,Sentinel Lymph Node Biopsy ,Lymphatic Metastasis ,Urology ,Humans ,Lymph Node Excision ,Lymph Nodes ,Prognosis ,Penile Neoplasms ,Neoplasm Staging ,Retrospective Studies - Abstract
OBJECTIVES: Following tumour positive sentinel lymph node biopsy (+DSNB), completion inguinal lymph node dissection (ILND) is negative in 84-89% of basins. Thus, ILND after +DSNB may be considered overtreatment resulting in substantial morbidity. This study aimed to develop a predictive model for additional inguinal lymph node metastases (LNM) at ILND following +DSNB using DSNB characteristics to identify a patient group in which ILND might be omitted.PATIENTS AND METHODS: A retrospective study of 407 inguinal basins with a +DSNB of penile cancer patients who underwent subsequent ILND from seven European centres. From the histopathology reports, the number of positive and negative lymph nodes, extranodal extension and size of the metastasis were recorded. Using bootstrapped logistic regression, variables were selected for the clinical prediction model based on the optimisation of Akaike's information criterion. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated for the resulting model. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model.RESULTS: 64 (16%) of +DSNB harboured additional LNM at ILND. The number of positive nodes at +DSNB (odds ratio (OR) 2.19; 95% confidence interval (CI) 1.17-4.00; p=0.01) and the largest metastasis size in mm (OR 1.06; 95%CI 1.03-1.10; p=0.001) were selected for the clinical prediction model. The AUC was 0.67 (95%CI 0.60-0.74). The DCA showed no clinical benefit of using the clinical prediction model.CONCLUSION: A small but clinically important group of basins harbour additional LNM at completion ILND following +DSNB. While DSNB characteristics were associated with additional LNM, they did not improve the selection of basins in which ILND could be omitted. Thus, completion ILND remains necessary in all basins with a +DSNB.
- Published
- 2021
18. Contemporary Treatment Patterns and Outcomes for Patients with Penile Squamous Cell Carcinoma: Identifying Management Gaps to Promote Multi-institutional Collaboration
- Author
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Oscar R. Brouwer, Gert De Meerleer, Filippo Pederzoli, Alberto Briganti, Patrizia Giannatempo, G. Daniel Grass, Peter A.S. Johnstone, Juan Chipollini, Dingwei Ye, Nick Watkin, Mounsif Azizi, Maarten Albersen, Friederike Haidl, Oliver W. Hakenberg, Marco Bandini, Yao Zhu, Daniele Raggi, Axel Heidenreich, Philippe E. Spiess, Antonio Augusto Ornellas, Laura Marandino, Andrea Necchi, Francesco Montorsi, Benjamin Ayres, Bandini, Marco, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A, Watkin, Nick, Ayres, Benjamin, Hakenberg, Oliver W, Heidenreich, Axel, Raggi, Daniele, Giannatempo, Patrizia, Marandino, Laura, Haidl, Friederike, Pederzoli, Filippo, Briganti, Alberto, Montorsi, Francesco, Chipollini, Juan, Azizi, Mounsif, De Meerleer, Gert, Brouwer, Oscar R, Grass, G Daniel, Johnstone, Peter A, Albersen, Maarten, Spiess, Philippe E, and Necchi, Andrea
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Penile squamous cell carcinoma ,business.industry ,Urology ,MEDLINE ,Internal medicine ,medicine ,Carcinoma, Squamous Cell ,Humans ,Radiology, Nuclear Medicine and imaging ,Surgery ,business ,Penile Neoplasms - Published
- 2020
19. European Association of Urology Guidelines Office Rapid Reaction Group: An Organisation-wide Collaborative Effort to Adapt the European Association of Urology Guidelines Recommendations to the Coronavirus Disease 2019 Era
- Author
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Christopher Harding, Stavros Gravas, Alberto Briganti, Oliver W. Hakenberg, Daniel S. Engeler, Bertil F.M. Blok, Morgan Rouprêt, Börje Ljungberg, Robert Shepherd, Alex Mottrie, James N'Dow, Alberto Breda, Gianluca Giannarini, Noam D. Kitrey, Nick Watkin, Maria P. Laguna, Arnulf Stenzl, J. Alfred Witjes, Marek Babjuk, Evangelos Liatsikos, Nicolaas Lumen, Ali Serdar Gözen, Jens Rassweiler, Nicolas Mottet, Jonathon Olsburgh, Christopher R. Chapple, Christian Türk, Julie Darraugh, Jens Sønksen, Bernardo Rocco, Li Ping Xie, Hendrik Van Poppel, Thomas Knoll, Axel Bex, Giovannalberto Pini, Philip Cornford, Emma Jane Smith, Ramnath Subramaniam, Rizwan Hamid, Gernot Bonkat, Manfred P. Wirth, Christian Radmayr, Nikolaos Sofikitis, Andrea Salonia, Maria J. Ribal, Urology, Biomedical Engineering and Physics, APH - Personalized Medicine, APH - Quality of Care, Ribal, M. J., Cornford, P., Briganti, A., Knoll, T., Gravas, S., Babjuk, M., Harding, C., Breda, A., Bex, A., Rassweiler, J. J., Gozen, A. S., Pini, G., Liatsikos, E., Giannarini, G., Mottrie, A., Subramaniam, R., Sofikitis, N., Rocco, B. M. C., Xie, L. -P., Witjes, J. A., Mottet, N., Ljungberg, B., Roupret, M., Laguna, M. P., Salonia, A., Bonkat, G., Blok, B. F. M., Turk, C., Radmayr, C., Kitrey, N. D., Engeler, D. S., Lumen, N., Hakenberg, O. W., Watkin, N., Hamid, R., Olsburgh, J., Darraugh, J., Shepherd, R., Smith, E. -J., Chapple, C. R., Stenzl, A., Van Poppel, H., Wirth, M., Sonksen, J., and N'Dow, J.
- Subjects
Urologic Diseases ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Isolation (health care) ,Association (object-oriented programming) ,Urology ,Pneumonia, Viral ,030232 urology & nephrology ,Globe ,Section Offices ,Guidelines ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Guidelines recommendations ,Pandemic ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,Medicine ,Humans ,Disease management (health) ,Pandemics ,Societies, Medical ,Science & Technology ,Health professionals ,Coronavirus disease 2019 ,business.industry ,SARS-CoV-2 ,COVID-19 ,Disease Management ,Urology & Nephrology ,Europe ,European Association of Urology ,Guidelines Office ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,business ,Coronavirus Infections ,Life Sciences & Biomedicine - Abstract
Contains fulltext : 220648.pdf (Publisher’s version ) (Closed access) The coronavirus disease 2019 (COVID-19) pandemic is unlike anything seen before by modern science-based medicine. Health systems across the world are struggling to manage it. Added to this struggle are the effects of social confinement and isolation. This brings into question whether the latest guidelines are relevant in this crisis. We aim to support urologists in this difficult situation by providing tools that can facilitate decision making, and to minimise the impact and risks for both patients and health professionals delivering urological care, whenever possible. We hope that the revised recommendations will assist urologist surgeons across the globe to guide the management of urological conditions during the current COVID-19 pandemic.
- Published
- 2020
20. MP33-01 PENILE LENGTH LOSS DURING NESBIT-TYPE SURGERY: A PROSPECTIVE STUDY
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Deji Akiboye, Nick Watkin, Benjamin Ayres, Jade Harrison, and Pareeta Patel
- Subjects
body regions ,medicine.medical_specialty ,business.industry ,Urology ,Convex side ,Medicine ,business ,Prospective cohort study ,Patient centered ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Nesbit’s-type procedures (tunical plication +/- incision) for Peyronie’s disease curvature necessarily shortens the convex side. Patient focused research has shown a comm...
- Published
- 2020
21. MP76-16 SURVIVAL OF NODE POSITIVE PENILE CANCER PATIENTS WHO RELAPSED FOLLOWING DEFINITIVE TREATMENT
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Nick Watkin, Delia Toomey, Benjamin Ayres, Mehran Afshar, Ruairidh Crawford, and Michael Ager
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,Node (networking) ,Medicine ,Penile cancer ,business ,medicine.disease - Published
- 2020
22. Update on organ preserving surgical strategies for penile cancer
- Author
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Anthony Emmanuel and Nick Watkin
- Subjects
Male ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,business.industry ,Urology ,General surgery ,030232 urology & nephrology ,Margins of Excision ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,medicine ,Penile cancer ,Humans ,business ,Organ Sparing Treatments ,Penile Neoplasms ,Penis - Abstract
With the passage of time, there has been a major paradigm shift in the surgical management of penile cancer from radical to organ preserving penile surgical techniques, with closer surgical margins which offer good oncological, cosmetic and functional outcomes with improved physical and psychosexual well-being. This article aims to provide an update of the current organ preserving surgical strategies for penile cancer.
- Published
- 2020
23. Lymph Node Staging in Clinically Negative Groin Nodes
- Author
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Nick Watkin
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Sentinel lymph node ,030232 urology & nephrology ,Nomogram ,Sentinel node ,medicine.disease ,03 medical and health sciences ,Dissection ,0302 clinical medicine ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Biopsy ,medicine ,Penile cancer ,Lymph ,Radiology ,business ,Lymph node - Abstract
Introduction Nodal involvement is the most important prognostic factor in patients with squamous cell carcinoma of the penis (SCCp). However, optimal staging of regional lymph node remains controversial. Methods The literature was reviewed to examine current management of regional lymph nodes in SCCp patients with clinically nonpalpable inguinal lymph nodes (cN0). Results Radiological staging and selective risk-profile nomograms are unreliable in the detection of occult micrometastases in cN0 patients. Prophylactic inguinal lymph node dissection (ILND) is associated with significant morbidity and a high rate of postoperative complications. Dynamic sentinel lymph node biopsy (DSNB) is a reliable minimally invasive surgical staging technique for cN0 patients. Ipsilateral ILND is indicated only in inguinal basins with positive DSNB. Conclusions DSNB has excellent performance characteristics in staging cN0 patients, with high sensitivity and a low morbidity rate.
- Published
- 2018
24. Risk factors and survival outcomes for upstaging after inguinal lymph node dissection for cN1 penile squamous cell carcinoma
- Author
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Axel Heidenreich, Aaron Dahmen, Friederike Haidl, Michael Ager, Maarten Albersen, Filippo Pederzoli, Dingwei Ye, Philippe E. Spiess, Nicholas H. Chakiryan, Roberto Salvioni, Oliver W. Hakenberg, Mario Catanzaro, Antonio Augusto Ornellas, Alberto Briganti, Marco Bandini, Yao Zhu, Laura Marandino, Nick Watkin, Andrea Necchi, Francesco Montorsi, and Eduard Roussel
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Inguinal Canal ,Logistic regression ,Risk Factors ,Internal medicine ,medicine ,Humans ,Penile cancer ,Penile Neoplasms ,Aged ,Chemotherapy ,business.industry ,Incidence (epidemiology) ,Middle Aged ,medicine.disease ,Survival Analysis ,Clinical trial ,Dissection ,Treatment Outcome ,Cohort ,Carcinoma, Squamous Cell ,Population study ,Lymph Nodes ,business - Abstract
OBJECTIVES To identify incidence and risk factors for upstaging from cN1 to pN2/N3 at inguinal lymphadenectomy (ILND) for penile cancer (pSCC). Our secondary objective is to assess survival outcomes and associations for cN1 patients undergoing ILND. SUBJECTS/PATIENTS AND METHODS Patients with pT≥1cN1cM0 pSCC who underwent bilateral ILND and had complete data were identified in a multi-institutional international cohort from 8 referral centers in 7 countries diagnosed from 1980 to 2017. Upstaging was defined as pN2/N3 at ILND. Multivariable logistic regression analysis was used to determine associations with upstaging, and Cox multivariable logistic regression analysis to determine associations with overall survival (OS). RESULTS Of 144 patients were included in the final study population. 84 patients (58%) were upstaged from cN1 to pN2/N3, and 25 (17%) were down staged to pN0. Upstaging was associated with pT3/T4 (OR 4.1, 95%CI 1.5-11.7, P < 0.01) and pTX (OR 7.1, 95CI 1.6-51.1, P = 0.02). Age, smoking status, HPV status, and LVI were not associated with upstaging. Age (HR 1.03/y, 95%CI 1.01-1.06, P < 0.01) and upstaging (HR 2.8, 95%CI 1.3-5.9, P < 0.01) were associated with worse OS. Upstaged patients had a 5-year OS of 49%, compared with 86% for patients who were not upstaged. CONCLUSION The majority of cN1 pSCC patients harbor a higher-risk disease state than their clinical staging suggests, especially those with higher pT stages. More intensive pre-operative workup may be warranted for these patients to identify upstaging prior to ILND and potentially qualify them for neoadjuvant chemotherapy or clinical trials.
- Published
- 2021
25. Reply by Authors
- Author
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Nicholas H. Chakiryan, Aaron Dahmen, Marco Bandini, Filippo Pederzoli, Laura Marandino, Maarten Albersen, Eduard Roussel, Yao Zhu, Ding-Wei Ye, Antonio A. Ornellas, Mario Catanzaro, Oliver W. Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Jad Chahoud, Alberto Briganti, Roberto Salvioni, Francesco Montorsi, Andrea Necchi, and Philippe E. Spiess
- Subjects
Urology - Published
- 2021
26. Developing a predictive model for additional lymph node metastases at inguinal lymph node dissection following positive sentinel node biopsy for penile cancer: An European multicentre evaluation
- Author
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Marchel Stuiver, Vijay K Sangar, Pedro Oliveira, Arie Parnham, M. Albersen, Hussain M. Alnajjar, I.J. Jong, Oscar R. Brouwer, S. Horenblas, Hack Jae Lee, A. Muneer, R.S. Djajadiningrat, B. Ayres, Eduard Roussel, Bin K. Kroon, W. Lam, Nick Watkin, Sarah R. Ottenhof, and H.M. De Vries
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Inguinal lymph nodes ,Dissection (medical) ,Sentinel node ,medicine.disease ,medicine.anatomical_structure ,Biopsy ,medicine ,Penile cancer ,Radiology ,business ,Lymph node - Published
- 2021
27. Risk factors for inguinal lymph node metastases in men with T1G2 penile cancer: a multi centre collaborative study
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Vijay K Sangar, Jakob Kristian Jakobsen, Esther W. C. Lee, A. Muneer, A. Maarten, H.M. De Vries, Eduard Roussel, O. Pedro, Hussain M. Alnajjar, Arie Parnham, Fabio Castiglione, Maurice Lau, Nicolò Schifano, Nick Watkin, Oscar R. Brouwer, Allaudin Issa, B. Ayres, and Christian D. Fankhauser
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Inguinal lymph nodes ,medicine ,Penile cancer ,Radiology ,Multi centre ,medicine.disease ,business - Published
- 2021
28. Reply to Amit Bansal, Ruchir Maheshwari, and Anant Kumar’s Letter to the Editor re: Beatriz Goulao, Sonya Carnell, Jing Shen, et al. Surgical Treatment for Recurrent Bulbar Urethral Stricture: A Randomised Open-label Superiority Trial of Open Urethroplasty Versus Endoscopic Urethrotomy (the OPEN Trial). Eur Urol 2020;78:572–80
- Author
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Graeme MacLennan, Luke Vale, Beatriz Goulao, and Nick Watkin
- Subjects
Male ,Urethral Stricture ,medicine.medical_specialty ,Letter to the editor ,Urethrotomy ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,Endoscopy ,Surgery ,Superiority Trial ,Urethra ,Humans ,Medicine ,Open label ,business ,Surgical treatment ,Bulbar urethral stricture - Published
- 2021
29. Longitudinal cohort analysis of patients with metastatic penile cancer treated in a large quaternary academic centre
- Author
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Reena Patel, Hiten Rh Patel, Ruairidh Crawford, Mehran Ashfar, Alison Tree, Benjamin Ayres, Nick Watkin, Wing K Liu, and Lisa Pickering
- Subjects
Oncology ,Chemotherapy ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Carcinoma ,Penile cancer ,Surgery ,Longitudinal cohort ,business ,Metastatic Penile Cancer - Abstract
Objective: This study aimed to provide real-world data on the multidisciplinary management of metastatic penile squamous-cell carcinoma (mpSCC) patients and their survival outcomes, particularly those who receive best supportive care (BSC). Methods: A retrospective analysis of 1720 patients, managed via a supra-regional penile-specialist multidisciplinary team was conducted between January 2006 and May 2020. Results: A total of 101 patients (median age 63 years; interquartile range 56–72 years; 73% ECOG 0/1) were included. Of these, 32% (32/101) had previously received adjuvant chemotherapy prior to metastatic recurrence, 58% (59/101) received chemotherapy and 42% (42/101) received BSC. Further, 17% (17/101) received second-line systemic therapy, and 3% (3/101) received third-line systemic therapy. For first-line systemic-therapy, there was a 46% (27/59) clinical benefit rate (CBR), with 9% (5/59) complete response, 15% (9/59) partial response and 22% (13/59) stable disease. Patients receiving second-line therapy ( n=17) had a 29% (5/17) CBR. Median progression-free survival for first- and second-line treatment was 3.2 and 2.2 months, respectively. Median overall survival (mOS) for all patients was 6.2 months. mOS for first-line chemotherapy, second-line chemotherapy and BSC patients was 7.2, 4.5 and 2.0 months, respectively. Conclusions: First-line platinum-based chemotherapy is associated with notable response rates in mpSCC patients. Agents with better response rates are needed urgently potentially in combination with platinum-based chemotherapy. Level of evidence: Level 2b.
- Published
- 2021
30. Long term functional and oncological outcomes of urethral reconstruction for invasive and non-invasive squamous carcinoma of the male urethra
- Author
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M. Skrodzka, J. Harrison, P. Patel, Nick Watkin, M. Kulkarni, and B. Ayres
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Non invasive ,medicine ,business ,Surgery ,Squamous carcinoma ,Term (time) ,Male urethra - Published
- 2021
31. Topical Therapy for non-invasive penile cancer (Tis)—updated results and toxicity
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Aditya Manjunath, Catherine M. Corbishley, Thomas Brenton, Nick Watkin, and Sarah Wylie
- Subjects
medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Imiquimod ,Disease ,Review Article ,TNM staging system ,Malignancy ,03 medical and health sciences ,0302 clinical medicine ,imiquimod (IQ) ,medicine ,Penile cancer ,Adverse effect ,business.industry ,Carcinoma in situ ,penile intraepithelial neoplasia (PeIN) ,5-flurouracil (5-FU) ,Carcinoma in situ (CIS) ,medicine.disease ,Dermatology ,Reproductive Medicine ,030220 oncology & carcinogenesis ,Penile Intraepithelial Neoplasia ,business ,medicine.drug - Abstract
Penile cancer is a rare malignancy estimated to affect 26,000 men globally each year. The association with penile cancer, in particular non-invasive disease, and human papilloma virus (HPV) is well known. Ninety-five percent of cases of penile cancer are squamous cell carcinoma (SCC), which are staged using the TNM staging system. Terminology describing the histological appearance of non-invasive penile cancer has changed with all cases grouped under the umbrella term of penile intraepithelial neoplasia (PeIN); either undifferentiated or differentiated. This replaces previous terms such as carcinoma in situ (CIS) and eponymous names such as Bowen's disease. This change is recognised by the World Health Organisation (WHO). The topical treatments most commonly used for PeIN are 5-fluorouracil (5-FU) and imiquimod (IQ). Other treatments such as photodynamic therapy (PDT) are used but to a lesser degree. The evidence for all of these treatments is heterogenous with no randomised data available. Overall up to 57% complete response has been reported with a low number of serious adverse events. In this article, we aim to review the available evidence for the topical treatment of non-invasive penile cancer specifically regarding its efficacy and toxicity.
- Published
- 2017
32. Identifying an optimal lymph node yield for penile squamous cell carcinoma: prognostic impact of surgical dissection
- Author
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Oliver W. Hakenberg, Yao Zhu, Luigi Mariani, Salim Cheriyan, Juan Chipollini, Andrea Necchi, Daniele Raggi, Roberto Salvioni, Michael Ager, Ding W. Ye, Salvatore Lo Vullo, Mounsif Azizi, P.E. Spiess, Axel Heidenreich, Mario Catanzaro, Antonio Augusto Ornellas, Paulo Ornellas, Nick Watkin, Chipollini, J, Azizi, M, Lo Vullo, S, Mariani, L, Zhu, Y, Ye, Dw, Ornellas, Aa, Watkin, N, Ager, M, Hakenberg, O, Heidenreich, A, Raggi, D, Catanzaro, M, Ornellas, P, Salvioni, R, Cheriyan, Sk, Necchi, A, and Spiess, Pe
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Inguinal Canal ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Medicine ,Penile cancer ,Humans ,Lymph node ,Survival rate ,Penile Neoplasms ,Aged ,Retrospective Studies ,business.industry ,Hazard ratio ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Prognosis ,Survival Rate ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Cohort ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Lymphadenectomy ,business - Abstract
OBJECTIVE To evaluate the prognostic impact of lymph node yield (LNY) on survival outcomes for penile squamous cell carcinoma (SCC). PATIENTS AND METHODS In all, 532 patients who underwent inguinal LN dissection (ILND) across tertiary referral centres from Europe, China, Brazil and North America were retrospectively evaluated. From this cohort, 198 patients received pelvic LND (PLND).We identified threshold values for ILND and PLND using receiver operating characteristic curves. We tested prognostic value of LNY for recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) using the Kaplan-Meir method and Cox proportional hazard regression models. RESULTS The median (interquartile [IQR]) age was 59 (49-68) years and the median (IQR) follow-up after ILND was 28 (12-68.2) months. Overall, 85% of the patients had bilateral dissections. The median (IQR) number of inguinal LNs removed was 15 (10-22). Of those receiving PLND, The median (IQR) number of LNs was 13 (8-19). A LNY of ≥15 was used for dichotomisation of ILND patients, and a LNY of ≥9 was used in the PLND cohort. Patients with a LNY ≥15 had significantly better 5-year OS vs patients with a LNY
- Published
- 2019
33. MP67-05 INCIDENCE AND PATTERNS OF CATHETER ASSOCIATED UTIS (CAUTIS) POST URETHROPLASTY
- Author
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Pareeta Patel, Justin Bendig, Nick Watkin, Davendra Sharma, and hack jae lee
- Subjects
medicine.medical_specialty ,Catheter ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,Incidence (epidemiology) ,medicine ,business ,Surgery - Published
- 2019
34. MP49-17 INTERNATIONAL MULTI-CENTER ANALYSIS OF FACTORS PREDICTING THE PRESENCE OF NON-SENTINEL NODE INGUINAL METASTASES IN PENILE CANCER PATIENTS UNDERGOING COMPLETION INGUINAL LYMPH NODE DISSECTION FOLLOWING POSITIVE SENTINEL NODE BIOPSY
- Author
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Jennifer Nowers, Mehran Afshar, Sarah Ottenhof, Rosa Djajadiningrat, Caroline English, Wayne Lam, Hong Kong, Benjamin Ayres, Simon Horenblas, and Nick Watkin
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Inguinal lymph nodes ,Non sentinel node ,Sentinel node ,medicine.disease ,Dissection ,Biopsy ,medicine ,Penile cancer ,Radiology ,business - Abstract
INTRODUCTION AND OBJECTIVES:Currently, penile cancer patients with impalpable inguinal lymph nodes routinely undergo dynamic sentinel node biopsy (DSNB) to diagnose metastatic spread to the inguina...
- Published
- 2019
35. MP73-14 RED CELL DISTRIBUTION WIDTH (RDW) AS A PREDICTOR OF SURVIVAL OUTCOMES WITH PALLIATIVE CHEMOTHERAPY FOR METASTATIC PENILE CANCER
- Author
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Lisa Pickering, Reena Patel, Alison Tree, Mark Mikhaeel, Mehran Afshar, Nick Watkin, Unaiza Qureshi, Louise English, and Benjamin Ayres
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,medicine ,Blood count ,Red blood cell distribution width ,Palliative chemotherapy ,business ,Metastatic Penile Cancer - Abstract
INTRODUCTION AND OBJECTIVES:Red cell distribution width (RDW) is a measure of size variability in circulating red cells reported as a part of full blood count analysis before initiating systemic th...
- Published
- 2019
36. MP49-10 PROGNOSTICATORS OF INGUINAL LYMPH NODE METASTASIS AND SURVIVAL IN CLINICAL NODE-NEGATIVE PENILE SQUAMOUS CELL CARCINOMA PATIENTS
- Author
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Mounsif Azizi, David C. Boulware, Salim K. Cheriyan, Charles C. Peyton, Salvatore Lo Vullo, Luigi Mariani, Yao Zhu, Ding-Wei Ye, Antonio Ornellas, Nick Watkin, Michael Ager, Oliver Hakenberg, Daniele Raggi, Mario Catanzaro, Roberto Salvioni, Juan Chipollini, Scott M. Gilbert, Andrea Necchi, and Philippe E. Spiess
- Subjects
Oncology ,medicine.medical_specialty ,Penile squamous cell carcinoma ,business.industry ,Urology ,Internal medicine ,Inguinal lymph nodes ,medicine ,Lymph node metastasis ,medicine.disease ,business ,Metastasis ,Node negative - Abstract
INTRODUCTION AND OBJECTIVES:The main prognostic factors for survival among patients with penile squamous cell carcinoma (PSCC) remain the presence and the extent of lymph node metastasis (LNM). Kno...
- Published
- 2019
37. MP49-08 IS AGE AN INDEPENDENT PREDICTOR FOR SURVIVAL OUTCOMES IN PENILE CANCER
- Author
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Mehran Afshar, Lisa Pickering, Benjamin Ayres, Louise English, Nick Watkin, and Alison Tree
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,Incidence (epidemiology) ,medicine ,Penile cancer ,Independent predictor ,medicine.disease ,business - Abstract
INTRODUCTION AND OBJECTIVES:Penile cancer incidence increases with age, most commonly being diagnosed in men over the age of 60 years. There is little evidence on the independent risk of age and pr...
- Published
- 2019
38. MP49-15 SURVEILLANCE CT ALGORITHM FOR NODE POSITIVE SQUAMOUS CELL CARCINOMA OF THE PENIS
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Alison Tree, Cathy Corbishley, Aditya Manjunath, Brendan Tinwell, Sylvia Yan, Benjamin Ayres, Michael Ager, Nick Watkin, and Mehran Afshar
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Urology ,Node (networking) ,medicine ,Basal cell ,Radiology ,business ,Penis - Abstract
INTRODUCTION AND OBJECTIVES:Evidence for best practice follow up of node positive SCC of the penis (SCCp) is scant. Our practice mirrors EAU guidelines; 3 monthly review CT (TAP) for 2 years and 6 ...
- Published
- 2019
39. MP49-11 RESULTS OF A 10 YEAR MULTICENTRE EXPERIENCE OF ADJUVANT RADIOTHERAPY FOR PN3 SQUAMOUS CELL CARCINOMA OF THE PENIS (SCCP)
- Author
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B. Ayres, Kelechi Njoku, Ian Eardley, Perric Crellin, Sharon Beesley, Lisa Pickering, Mehran Afshar, Mamoun Elmamoun, Lona Vyas, Angus Roninson, Oliver Kayes, Maria Serra, Ann Henry, Alison Tree, Nick Watkin, and Michael Ager
- Subjects
endocrine system ,Adjuvant radiotherapy ,medicine.medical_specialty ,genetic structures ,business.industry ,Urology ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,medicine ,Basal cell ,Radiology ,business ,Penis - Abstract
INTRODUCTION AND OBJECTIVES:Evidence for adjuvant radiotherapy in the management of node positive squamous cell carcinoma of the penis (SCCp) is scant owing to the rarity of the disease. Our supra-...
- Published
- 2019
40. The International Penile Advanced Cancer Trial (InPACT): Rationale and Current Status
- Author
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Curtis A. Pettaway, Emma Hall, Nick Watkin, Daniel J. Canter, and Steve Nicholson
- Subjects
Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,MEDLINE ,Disease ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carcinoma ,Penile cancer ,Humans ,Prospective Studies ,Prospective cohort study ,Penile Neoplasms ,Neoplasm Staging ,Randomized Controlled Trials as Topic ,business.industry ,General surgery ,medicine.disease ,Advanced cancer ,Clinical trial ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Presentation (obstetrics) ,business - Abstract
The historic international penile cancer trial InPACT is now open and accruing patients in the UK and USA. The trial is geared to answer important questions for patients with evidence of inguinal lymph node disease at presentation. This clinical trial update provides an overview of the study and progress to date.
- Published
- 2019
41. Nomogram-based prediction of overall survival after regional lymph node dissection and the role of perioperative chemotherapy in penile squamous cell carcinoma: A retrospective multicenter study
- Author
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Michael Ager, Nick Watkin, Philippe E. Spiess, Salvatore Lo Vullo, Oliver W. Hakenberg, Mounsif Azizi, Andrea Necchi, Yao Zhu, Daniele Raggi, Roberto Salvioni, Luigi Mariani, Dingwei Ye, Juan Chipollini, Axel Heidenreich, Mario Catanzaro, Antonio Augusto Ornellas, Necchi, A, Lo Vullo, S, Mariani, L, Zhu, Y, Ye, Dw, Ornellas, Aa, Watkin, N, Ager, M, Hakenberg, Ow, Heidenreich, A, Raggi, D, Catanzaro, M, Salvioni, R, Chipollini, J, Azizi, M, and Spiess, Pe
- Subjects
Oncology ,Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Perioperative Care ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Carcinoma ,Humans ,Pathological ,Penile Neoplasms ,Aged ,Retrospective Studies ,Chemotherapy ,business.industry ,Proportional hazards model ,Retrospective cohort study ,Perioperative ,Nomogram ,Middle Aged ,medicine.disease ,Nomograms ,Clinical research ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,Lymph Nodes ,business - Abstract
To improve the prognostic allocation of patients with penile squamous-cell carcinoma (PSCC) receiving regional lymph node dissection (LND).An international, multicenter, retrospective study was performed on patients with PSCC who received regional LND, with or without perioperative therapy, from 1980 to 2017. We first used a random forest (RF) method with missing data imputation. Additionally, data were modeled using Cox proportional hazard regression, and a Cox model was also fit including prespecified variables. Based on the latter model, a nomogram for estimating 12-month and 24-month overall survival (OS) was developed.There were 743 patients who received LND at 7 referral centers from Europe, the USA, Brazil, and China. Of these patients, 689 were analyzed: 86 (12.5%) received neoadjuvant chemotherapy (NAC); 171 (24.8%) received adjuvant chemotherapy (AC), and 74 (10.7%) received adjuvant radiotherapy. The variables significantly associated with OS were age (P0.001), the pathologically involved/total removed LN ratio (P0.001), pN stage (overall P0.001), and NAC (P = 0.013). NAC and AC were ineffective in N1-2 patients (clinical and pathological, respectively), whereas they provided OS improvements in N3 patients. Finally, we developed a nomogram predicting 12- and 24-month OS based on prespecified variables (c-index: 0.75). The study is limited by its retrospective nature.We propose a tool that can be offered as an aid to physicians to enhance decision-making, clinical research, and patient counseling whenever LND is needed for PSCC. Administration of NAC and AC should be restricted to clinical and pathological N3 patients, respectively.
- Published
- 2018
42. MP11-09 REGRESSION-TREE ANALYSIS FOR IDENTIFYING THE BEST CANDIDATES TO NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH CLINICAL NODE-POSITIVE PENILE SQUAMOUS-CELL CARCINOMA
- Author
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Maarten Albersen, Oliver W. Hakenberg, Daniele Raggi, Filippo Pederzoli, Michael Ager, Alberto Briganti, Friederike Haidl, Juan Chipollini, Marco Bandini, Yao Zhu, Nick Watkin, Oscar R. Brower, Axel Heidenreich, Mario Catanzaro, Philippe E. Spiess, Antonio Augusto Ornellas, Elio Mazzone, Dingwei Ye, Laura Marandino, Mounsif Azizi, Andrea Necchi, and Francesco Montorsi
- Subjects
Oncology ,medicine.medical_specialty ,Chemotherapy ,Penile squamous cell carcinoma ,business.industry ,Urology ,Node (networking) ,medicine.medical_treatment ,Regression tree analysis ,Inguinal lymph nodes ,medicine.disease ,stomatognathic diseases ,Internal medicine ,medicine ,Overall survival ,Carcinoma ,In patient ,business - Abstract
INTRODUCTION AND OBJECTIVE:Penile squamous-cell carcinoma (PSCC) patients (pts) with palpable inguinal lymph node disease have a poor overall survival (OS). Thus, they could be optimal candidate fo...
- Published
- 2020
43. MP11-08 DEVELOPMENT OF A RISK CALCULATOR OF RECURRENCE IN INGUINAL LYMPH-NODE METASTATIC (ILNM) PATIENTS WITH SURGICALLY-RESECTED PENILE SQUAMOUS-CELL CARCINOMA (PSCC)
- Author
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Filippo Pederzoli, Mario Catanzaro, Antonio Augusto Ornellas, Laura Marandino, Michael Ager, Mounsif Azizi, Alberto Briganti, Oscar R. Brower, Oliver W. Hakenberg, Axel Heidenreich, Maarten Albersen, Daniele Raggi, Yao Zhu, Philippe E. Spiess, Nick Watkin, Dingwei Ye, Andrea Necchi, Francesco Montorsi, Friederike Haidl, Juan Chipollini, and Marco Bandini
- Subjects
medicine.medical_specialty ,business.industry ,Penile squamous cell carcinoma ,Urology ,Inguinal lymph nodes ,Medicine ,Radiology ,business - Published
- 2020
44. MP84-14 THE IMPACT OF MICRO-METASTATIC PELVIC LYMPH NODE INVOLVEMENT ON 3 YEAR SURVIVAL IN SQUAMOUS CELL CARCINOMA OF THE PENIS
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R. Issa, Brendan Tinwell, Alison Tree, Benjamin Ayres, Cathy Corbishley, and Nick Watkin
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Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Urology ,medicine ,Basal cell ,business ,Lymph node ,Penis - Published
- 2018
45. MP37-11 CAN SQUAMOUS CELL CARCINOMA OF THE ANTERIOR MALE URETHRA BE MANAGED BY FOLLOWING A PENILE CANCER BEST PRACTICE PATHWAY?
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Hussain M. Alnajjar, Catherine M. Corbishley, Benjamin Ayres, Nick Watkin, and Aditya Manjunath
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medicine.medical_specialty ,business.industry ,Urology ,medicine ,Penile cancer ,Basal cell ,medicine.disease ,business ,Male urethra - Published
- 2018
46. PD44-01 THE DEVELOPMENT OF A VALIDATED PATIENT REPORTED OUTCOME MEASURE (PROM) FOR PENILE CURVATURE SURGERY
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Nick Watkin, Angus J.D. Campbell, Pareeta Patel, and Richard Akiboye
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Measure (physics) ,Medicine ,Patient-reported outcome ,Penile curvature ,Prom ,business ,Surgery - Published
- 2018
47. MP37-14 SURGICAL MANAGEMENT OF THE CLINICALLY NEGATIVE CONTRALATERAL GROIN WHEN THE IPSILATERAL GROIN IS CLINICALLY AND PATHOLOGICALLY POSITIVE IN SQUAMOUS CELL CARCINOMA OF THE PENIS
- Author
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Brendan Tinwell, Sylvia Yan, Wayne Lam, Cathy Corbishley, Michael Ager, Benjamin Ayres, Nick Watkin, and Aditya Manjunath
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medicine.medical_specialty ,medicine.anatomical_structure ,Groin ,business.industry ,Urology ,Medicine ,Basal cell ,business ,Penis ,Surgery - Published
- 2018
48. Risks and Benefits of Adjuvant Radiotherapy After Inguinal Lymphadenectomy in Node-positive Penile Cancer: A Systematic Review by the European Association of Urology Penile Cancer Guidelines Panel
- Author
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Eva Compérat, Yuhong Yuan, Suks Minhas, Oliver W. Hakenberg, Nick Watkin, Andrea Necchi, Alberto Coscione, Temitope E Adewuyi, Ekelechi MacPepple, Lorenzo Marconi, Thomas B. Lam, Richard Robinson, Steven MacLennan, Robinson, R, Marconi, L, Macpepple, E, Hakenberg, Ow, Watkin, N, Yuan, Yh, Lam, T, Maclennan, S, Adewuyi, Te, Coscione, A, Minhas, S, Comperat, Em, and Necchi, A
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Inguinal Canal ,Inguinal lymphadenectomy ,Cancer recurrence ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Penile cancer ,Humans ,Risks and benefits ,Penile Neoplasms ,Neoplasm Staging ,Retrospective Studies ,Adjuvant radiotherapy ,business.industry ,Extranodal Extension ,medicine.disease ,Radiation therapy ,Systematic review ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Practice Guidelines as Topic ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Radiotherapy, Adjuvant ,Lymph Nodes ,business - Abstract
Context Management of men with penile squamous cell carcinoma (PSCC) who have high-risk features following radical inguinal lymphadenectomy (ILND) remains controversial. European Association of Urology guidelines state that adjuvant inguinal radiotherapy (AIRT) is “not generally recommended”. Despite this, many centres continue to offer AIRT to a subset of men. Objective To undertake a systematic review of the evidence on AIRT in node-positive men with PSCC. Evidence acquisition A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with no language or date restriction. Inclusion criteria were men with PSCC, pathologically staged inguinal node positive after ILND. The intervention included ILND with AIRT compared with ILND alone. Primary outcomes were relapse-free survival and toxicity. Risk of bias assessment was undertaken. Evidence synthesis A total of 913 abstracts were identified and screened independently by two reviewers. Seven studies were eligible for inclusion: six full-text manuscripts and one conference abstract. All were retrospective series and at a high risk of bias. The selected studies included 1605 men. Indications for AIRT varied but were typically involvement of two or more inguinal nodes or extranodal extension. Regional recurrence rate following AIRT was reported at 10–91.7%. Only one study reported on toxicity. Two studies compared recurrence and survival between men who received and who did not receive AIRT, with no significant difference (p > 0.05). Conclusions The evidence indicates that men treated with AIRT do not gain benefit with respect to relapse or survival. Uncertainty remains due to the retrospective nature and high risks of bias across the evidence. Given the lack of evidence supporting AIRT, it cannot be recommended for routine practice. Patient summary Men with penile cancer who have involvement of the inguinal lymph nodes are at a high risk of cancer recurrence and death. We reviewed the literature to see if radiation treatment after removal of the nodes provided benefit. We did not find any good-quality evidence supporting this treatment, and hence it cannot be recommended.
- Published
- 2018
49. The Prognostic Value of PIK3CA Copy Number Gain in Penile Cancer
- Author
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Cathy Corbishley, Brendan Tinwell, Susannah La Touche, Anthony Adimonye, Daniel M. Berney, Yong-Jie Lu, Elzbieta Stankiewicz, Sakunthala C. Kudahetti, and Nick Watkin
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0301 basic medicine ,Copy number gain ,Oncology ,medicine.medical_specialty ,Tissue microarray ,medicine.diagnostic_test ,business.industry ,Penile squamous cell carcinoma ,Urology ,Disease ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Text mining ,030220 oncology & carcinogenesis ,Internal medicine ,Medicine ,Penile cancer ,Stage (cooking) ,business ,neoplasms ,Fluorescence in situ hybridization - Abstract
To determine whether phosphatidylinositol-4,5-bisphosphate 3- kinase, catalytic subunit alpha (PIK3CA) copy number gain in penile cancer has prognostic value and association with histopathological parameters, human papillomavirus (HPV), and clinical outcome.PIK3CA copy number status was assessed with fluorescence in situ hybridization in tissue microarrays generated from archival paraffin embedded blocks of 199 patients with primary penile squamous cell carcinoma (PSCC). HPV DNA was detected with INNO-LiPA assay. Follow-up data were available for 174 patients. PIK3CA copy number status was correlated with histopathological parameters, high-risk HPV, cancer-specific survival and time to recurrence.PIK3CA copy number gain was found in 84/199 (42%) of penile cancer cases. PIK3CA copy number gain was associated with tumor subtype, grade, and stage (P = .0028, P.0001, and P = .0397, respectively), but not with lymph node status (P = .2902). PIK3CA copy number gain showed a tendency to associate with cancer-specific survival (HR = 1.76, 95% CI; 0.94-3.3; P = .0753). In multivariate analysis, PIK3CA copy number gain was found to have no prognostic value for cancer-specific survival (P = .677). Only lymph node metastasis, high tumor grade and stage were found to be independent prognostic factors for cancer-specific survival.PIK3CA copy number gain could be used as a marker of high-risk disease as it correlates with more aggressive PSCC histological subtypes and higher tumor grade and stage. However, it shows no significant association with lymph node metastasis or prognostic value for cancer-specific survival in PSCC.
- Published
- 2017
50. Development and external validation of a prognostic tool for prediction of cancer-specific mortality after complete loco-regional pathological staging for squamous cell carcinoma of the penis
- Author
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Simon Horenblas, Quoc-Dien Trinh, Niels M. Graafland, Nick Watkin, Rosa S. Djajadiningrat, Hussain M. Alnajjar, Pierre I. Karakiewicz, and Maxine Sun
- Subjects
Male ,medicine.medical_specialty ,Urology ,Pathological staging ,Kaplan-Meier Estimate ,Groin ,Metastasis ,Biopsy ,medicine ,Humans ,Prospective Studies ,Extranodal Involvement ,Penile Neoplasms ,Neoplasm Staging ,medicine.diagnostic_test ,Proportional hazards model ,business.industry ,Reproducibility of Results ,Nomogram ,Prognosis ,medicine.disease ,Surgery ,Nomograms ,Dissection ,medicine.anatomical_structure ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Radiology ,business ,Penis - Abstract
Objective To develop a novel postoperative prognostic tool, which attempts to integrate both pathological tumour stage and histopathological factors, for prediction of cancer-specific mortality (CSM) of squamous cell carcinoma of the penis (SCCP). Patients and Methods Patients with SCCP treated with inguinal lymph node dissection (ILND) or sentinel LN biopsy at a single institution were used for nomogram development and internal validation (n = 434), while a second cohort was used for external validation (n = 338). Multivariable Cox proportional hazards were used to examine the prognostic ability of patient age, a modified tumour staging that distinguishes between spongiosum and cavernosum body ingrowth tumours, a modified LN staging that integrates information on presence/absence of LN metastasis, extent of inguinal LN metastases, pelvic LN involvement, and extranodal involvement, and tumour grade. Model performance was quantified using measures of discrimination and calibration. Results Overall, 36% of patients had positive LN metastases (n = 156). In univariable analyses, the modified tumour and LN staging systems were statistically significantly associated with CSM, and remained in the final model with a discrimination of 89% within internal validation, and 95% within external validation. Calibration was nearly perfect. Conclusions The newly developed model integrates important prognostic factors, which existing models do not consider. Its performance was highly accurate using measures of discrimination and calibration.
- Published
- 2015
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