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Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines

Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines
Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines

Penile mucosal melanoma is an aggressive and rare genital malignancy. The aim of the present study was to review the management and outcomes of a homogenous cohort of patients with histologically confirmed penile mucosal melanoma, at a single specialist centre. A retrospective review of an institutional database identified patients with penile mucosal melanoma over a 10-year period. Patient demographics, histopathological characteristics, type of primary surgery, recurrence, presence of metastatic disease and molecular markers were evaluated. The management of the patients was initially based on the European Association of Urology (EAU) penile cancer guidelines which are primarily for squamous cell carcinoma with inputs from a melanoma multidisciplinary team. Twelve patients with penile mucosal melanoma were analysed. Median [interquartile range (IQR)] age was 69.5 (67.25-81) years. The overall median follow-up (IQR) was 69.5 (20-114) months, while median follow-up for cancer-specific survival (CSS) was 11.5 (8-37) months. Location of the primary tumour was glans penis (n = 7), urethra (n = 2) and inner prepuce (n = 3). The CSS at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0%, respectively. The recurrence-free survival at 1, 3 and 5 months after the primary surgery was 90%, 67% and 56%, respectively. All patients with metastatic disease or with inguinal lymph node invasion at presentation, died within 25 months of the primary diagnosis. Management based on the modified EAU penile cancer guidelines still led to poor outcomes. We present a management diagram based on our experience.

0960-8931
27-34
Cakir, Omer Onur
1c15426d-efa3-4d8b-9cfd-659bcdb73ae9
Pozzi, Edoardo
52a19d12-dce1-42be-82dc-98dc5d4c7d2d
Castiglione, Fabio
24fb888c-fed8-4a47-80b9-196d5a2b8383
Freeman, Alex
40ab3381-31c9-4660-8959-9c31e7377eec
Haider, Aiman
3e1f400b-305c-40a9-9162-b8b8a090ba81
Rees, Rowland
4180ed50-e1eb-4f41-90e8-9e9ccb0aba18
Alnajjar, Hussain M
d7fc2d3a-db8f-4432-b6ac-7a656aaf950f
Bunker, Christopher
55161a6c-9c11-42e2-8714-4ad028617624
Muneer, Asif
a78d14a3-2efc-4cf2-a52b-c39eeb1c05a8
Cakir, Omer Onur
1c15426d-efa3-4d8b-9cfd-659bcdb73ae9
Pozzi, Edoardo
52a19d12-dce1-42be-82dc-98dc5d4c7d2d
Castiglione, Fabio
24fb888c-fed8-4a47-80b9-196d5a2b8383
Freeman, Alex
40ab3381-31c9-4660-8959-9c31e7377eec
Haider, Aiman
3e1f400b-305c-40a9-9162-b8b8a090ba81
Rees, Rowland
4180ed50-e1eb-4f41-90e8-9e9ccb0aba18
Alnajjar, Hussain M
d7fc2d3a-db8f-4432-b6ac-7a656aaf950f
Bunker, Christopher
55161a6c-9c11-42e2-8714-4ad028617624
Muneer, Asif
a78d14a3-2efc-4cf2-a52b-c39eeb1c05a8

Cakir, Omer Onur, Pozzi, Edoardo, Castiglione, Fabio, Freeman, Alex, Haider, Aiman, Rees, Rowland, Alnajjar, Hussain M, Bunker, Christopher and Muneer, Asif (2022) Clinical features, molecular characteristics and surgical management of primary penile mucosal melanoma based on the European Association of Urology Penile Cancer Guidelines. Melanoma Research, 32 (1), 27-34. (doi:10.1097/CMR.0000000000000788).

Record type: Article

Abstract

Penile mucosal melanoma is an aggressive and rare genital malignancy. The aim of the present study was to review the management and outcomes of a homogenous cohort of patients with histologically confirmed penile mucosal melanoma, at a single specialist centre. A retrospective review of an institutional database identified patients with penile mucosal melanoma over a 10-year period. Patient demographics, histopathological characteristics, type of primary surgery, recurrence, presence of metastatic disease and molecular markers were evaluated. The management of the patients was initially based on the European Association of Urology (EAU) penile cancer guidelines which are primarily for squamous cell carcinoma with inputs from a melanoma multidisciplinary team. Twelve patients with penile mucosal melanoma were analysed. Median [interquartile range (IQR)] age was 69.5 (67.25-81) years. The overall median follow-up (IQR) was 69.5 (20-114) months, while median follow-up for cancer-specific survival (CSS) was 11.5 (8-37) months. Location of the primary tumour was glans penis (n = 7), urethra (n = 2) and inner prepuce (n = 3). The CSS at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0%, respectively. The recurrence-free survival at 1, 3 and 5 months after the primary surgery was 90%, 67% and 56%, respectively. All patients with metastatic disease or with inguinal lymph node invasion at presentation, died within 25 months of the primary diagnosis. Management based on the modified EAU penile cancer guidelines still led to poor outcomes. We present a management diagram based on our experience.

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More information

Accepted/In Press date: 18 September 2021
Published date: 1 February 2022
Additional Information: This study is supported by the NIHR Biomedical Research Centre UCLH. A.M. acknowledges the Melanoma Focus Ano-uro-genital Mucosal Melanoma consensus group. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for- profit sectors

Identifiers

Local EPrints ID: 455478
URI: http://eprints.soton.ac.uk/id/eprint/455478
ISSN: 0960-8931
PURE UUID: 9a77077f-0354-4d73-92cb-eb987dcee102

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Date deposited: 22 Mar 2022 17:43
Last modified: 18 Oct 2022 17:05

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Contributors

Author: Omer Onur Cakir
Author: Edoardo Pozzi
Author: Fabio Castiglione
Author: Alex Freeman
Author: Aiman Haider
Author: Rowland Rees
Author: Hussain M Alnajjar
Author: Christopher Bunker
Author: Asif Muneer

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