Cáncer de pene. Nuestra experiencia en 15 años
Cancer of the penis. Our experience in 15 years
Carlos Di Capua Sacoto1
, Sátur Lujan Marco, Gonzalo Morales Solchaga, Alberto Budía Alba, L. José Pontones Moreno, F. Juan Cruz Jiménez
Autor para correspondencia
carlosdicapua@hotmail.com
Correspondencia autor: Dr. Carlos Di Capua Sacoto Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009 Valencia Tel.: 963 862 700
Correspondencia autor: Dr. Carlos Di Capua Sacoto Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009 Valencia Tel.: 963 862 700
Servicio de Urología. Hospital Universitario La Fe. Valencia, España
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Nuestra experiencia en 15 años" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "143" "paginaFinal" => "148" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Di Capua Sacoto, Sátur Lujan Marco, Gonzalo Morales Solchaga, Alberto Budía Alba, L. José Pontones Moreno, F. Juan Cruz Jiménez" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Carlos" "apellidos" => "Di Capua Sacoto" "email" => array:1 [ 0 => "carlosdicapua@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Sátur" "apellidos" => "Lujan Marco" ] 2 => array:2 [ "nombre" => "Gonzalo" "apellidos" => "Morales Solchaga" ] 3 => array:2 [ "nombre" => "Alberto" "apellidos" => "Budía Alba" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "José Pontones Moreno" ] 5 => array:2 [ "nombre" => "F." "apellidos" => "Juan Cruz Jiménez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología. Hospital Universitario La Fe. Valencia, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Carlos Di Capua Sacoto Servicio de Urología. Hospital Universitario La Fe Avda. Campanar, 21- 46009 Valencia Tel.: 963 862 700" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cancer of the penis. Our experience in 15 years" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-09-30" "fechaAceptado" => "2008-10-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88845" "palabras" => array:3 [ 0 => "Cáncer" 1 => "Pene" 2 => "Supervivencia" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec88846" "palabras" => array:3 [ 0 => "Cancer" 1 => "Penis" 2 => "Surveillance" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Revisión y análisis de los factores de riesgo, diagnóstico, tratamiento y evolución del cáncer de pene.</p> <span class="elsevierStyleSectionTitle">Material y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio descriptivo retrospectivo desde 1992 hasta el 2007, en el que se incluyeron 47 pacientes con diagnóstico de cáncer de pene tratados en nuestro servicio. Se analiza factores de riesgo, síntomas, diagnóstico, tratamiento, y evolución de los pacientes. El estadiaje clínico y anatomopatológico se hizo acorde a la clasificación TNM, teniendo en cuenta el examen físico, pruebas de diagnóstico por imagen y hallazgos de la pieza quirúrgica. El tiempo medio de seguimiento es de 50 meses (rango 12 a 120 meses). Para el análisis estadístico univariante se utilizo la prueba de Chi-cuadrado, y para el análisis de la supervivencia el método de Kaplan Meir.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad media de los pacientes fue de 60 años (28-91 años), siendo el 95% de ellos mayores de 50. Presentaron adenopatías al diagnóstico 16 pacientes (34%) siendo las más frecuente (62%) las adenopatías unilaterales inguinales. Ningún caso presentó metástasis a distancia. De los 27 casos (57%) a los que se les realizó calcio en sangre al momento del diagnostico, encontramos hipercalcemia en 8 (30%). El tratamiento fue quirúrgico en la mayoría (95%), siendo la técnica más empleada la penectomía parcial en 25 (53%). En 4 sujetos se decidió la radioterapia como tratamiento inicial. A 14 se les realizó una linfaadenectomía, siendo la técnica más frecuente la inguinal bilateral profunda (8 pacientes). Respecto al estadio TNM, la mayoría de pacientes presentaron un estadio clínico localizado: t1n0m0 23 %, t2n0m0 27%. El diagnóstico anatomopatológico en el 100% de los casos fue carcinoma epidermoide (80% fue bien diferenciado) En la última revisión 31 casos (76%) estaban libres de enfermedad. Hubo 11 (24%) casos que presentaron recidiva y fueron tratados: 3 con radioterapia, 7 cirugía de rescate y 1 de ellos con quimioterapia. Los factores pronósticos adversos más importantes son la presencia de adenopatías, el estadio clínico al diagnóstico y el grado de diferenciación celular (p=0,001) Once pacientes fallecieron a lo largo del seguimiento, 9 de los cuales por progresión de la enfermedad.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El carcinoma de pene sigue siendo una enfermedad maligna poco frecuente en nuestro medio. Los factores pronósticos adversos más importantes son la presencia de adenopatías, el estadio clínico al diagnóstico y el grado de diferenciación celular. El tratamiento más eficaz del cáncer de pene es quirúrgico, reservando la quimioterapia y radioterapia para adyuvancia o terapia de rescate. La hipercalcemia es un hallazgo frecuente cuando los pacientes presentan adenopatías.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To review and analysis the diagnosis, treatment, evolution, and risk factors of the penis cancer.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We carried out a retrospective study between 1992 and 2007. We included 47 patients with penis cancer diagnose of treated in our service. We analyzed risk factors, symptoms, diagnosis and treatment. The staging was done according to the TNM classification, taking into account the physical exam, radiology and the surgical findings. The average time of follow-up was 50 months (range 12 to 120 months). For univariate statistical analysis the Chi-square test was used, and for the survival the method of Kaplan Meir.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mean age was 60 years (28-91 years), being 95% older than 50. At the diagnosis 16 patients (34%) had lymphatic nodes, being the most frequent location was unilateral inguinal nodes (62%). Of the 27 cases (57%) who underwent blood calcium check at the time of diagnosis, we found hypercalcaemia in 8 patients (30%). The surgical treatment was the gold standard treatment. The technique more frequently employed was the partial penectomy 25 (53%). 4 patients received radiotherapy as inicial treatment. Lymphadenectomy was performed in 14 patients, mostly bilateral inguinal lymphadenectomy (8 patients). The pathology finding at 100% of the cases was squamous cell carcinoma (80% well differentiated). Regarding to the TNM, most of the patients had a clinical stage located: t1n0m0 23%, t2n0m0 27%. The most significant adverse prognostic factors were the presence of lymph nodes, clinical stage at the diagnosis and the degree of cell differentiation (p = 0001). At the last review 36 (76%) cases were free of disease. There were 11 (24%) cases that presented recurrence and were treated: 3 patients with radiotherapy, surgery was used in 7 patients and 1 patient with chemotherapy. Eleven patients died during follor up, 9 of thes from disease progression.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The carcinoma of the penis remains a rare malignancy in our centre. Hypercalcemia is a common finding when patients have lymph nodes. The most significant adverse prognostic factors were the presence of lymph nodes, clinical stage at the diagnosis and the degree of cell differentiation. The most effective treatment for cancer of the penis is surgery reserving chemotherapy and radiation therapy for the recurrence.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "cáncer de pene" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Solsona" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "actas Urol Esp" "fecha" => "2002" "volumen" => "26" "numero" => "8" "paginaInicial" => "525" "paginaFinal" => "531" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12448169" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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| 2020 Octubre | 0 | 1 | 1 |
| 2020 Septiembre | 0 | 7 | 7 |
| 2020 Agosto | 0 | 10 | 10 |
| 2020 Julio | 0 | 1 | 1 |
| 2020 Junio | 0 | 3 | 3 |
| 2020 Mayo | 0 | 6 | 6 |
| 2020 Abril | 0 | 4 | 4 |
| 2020 Marzo | 0 | 4 | 4 |
| 2020 Febrero | 0 | 4 | 4 |
| 2020 Enero | 0 | 17 | 17 |
| 2019 Diciembre | 0 | 11 | 11 |
| 2019 Noviembre | 0 | 9 | 9 |
| 2019 Octubre | 0 | 10 | 10 |
| 2019 Septiembre | 0 | 8 | 8 |
| 2019 Agosto | 0 | 5 | 5 |
| 2019 Julio | 0 | 12 | 12 |
| 2019 Junio | 3 | 27 | 30 |
| 2019 Mayo | 0 | 67 | 67 |
| 2019 Abril | 0 | 27 | 27 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Febrero | 0 | 11 | 11 |
| 2019 Enero | 0 | 3 | 3 |
| 2018 Diciembre | 0 | 15 | 15 |
| 2018 Noviembre | 0 | 11 | 11 |
| 2018 Octubre | 0 | 27 | 27 |
| 2018 Septiembre | 0 | 1 | 1 |
| 2018 Agosto | 0 | 5 | 5 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Junio | 1 | 1 | 2 |
| 2018 Mayo | 0 | 1 | 1 |
| 2018 Abril | 0 | 3 | 3 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 4 | 3 | 7 |
| 2018 Enero | 4 | 7 | 11 |
| 2017 Diciembre | 1 | 13 | 14 |
| 2017 Noviembre | 6 | 9 | 15 |
| 2017 Octubre | 9 | 17 | 26 |
| 2017 Septiembre | 3 | 20 | 23 |
| 2017 Agosto | 5 | 5 | 10 |
| 2017 Julio | 6 | 10 | 16 |
| 2017 Junio | 6 | 7 | 13 |
| 2017 Mayo | 6 | 13 | 19 |
| 2017 Abril | 9 | 14 | 23 |
| 2017 Marzo | 10 | 24 | 34 |
| 2017 Febrero | 9 | 10 | 19 |
| 2017 Enero | 6 | 8 | 14 |
| 2016 Diciembre | 25 | 23 | 48 |
| 2016 Noviembre | 32 | 18 | 50 |
| 2016 Octubre | 31 | 22 | 53 |
| 2016 Septiembre | 18 | 12 | 30 |
| 2016 Agosto | 15 | 4 | 19 |
| 2016 Julio | 14 | 1 | 15 |
| 2016 Junio | 27 | 21 | 48 |
| 2016 Mayo | 16 | 21 | 37 |
| 2016 Abril | 24 | 27 | 51 |
| 2016 Marzo | 17 | 21 | 38 |
| 2016 Febrero | 22 | 38 | 60 |
| 2016 Enero | 14 | 34 | 48 |
| 2015 Diciembre | 15 | 19 | 34 |
| 2015 Noviembre | 18 | 10 | 28 |
| 2015 Octubre | 15 | 21 | 36 |
| 2015 Septiembre | 19 | 13 | 32 |
| 2015 Agosto | 16 | 11 | 27 |
| 2015 Julio | 8 | 8 | 16 |
| 2015 Junio | 9 | 4 | 13 |
| 2015 Mayo | 4 | 5 | 9 |
| 2015 Abril | 10 | 10 | 20 |
| 2015 Marzo | 5 | 3 | 8 |
| 2015 Febrero | 1 | 4 | 5 |
| 2015 Enero | 6 | 1 | 7 |
| 2014 Diciembre | 14 | 8 | 22 |
| 2014 Noviembre | 9 | 0 | 9 |
| 2014 Octubre | 7 | 3 | 10 |
| 2014 Septiembre | 20 | 1 | 21 |
| 2014 Agosto | 6 | 1 | 7 |
| 2014 Julio | 17 | 0 | 17 |
| 2014 Junio | 10 | 3 | 13 |
| 2014 Mayo | 2 | 0 | 2 |
| 2014 Abril | 3 | 3 | 6 |
| 2014 Marzo | 12 | 2 | 14 |
| 2014 Febrero | 4 | 3 | 7 |
| 2014 Enero | 6 | 1 | 7 |
| 2013 Diciembre | 8 | 3 | 11 |
| 2013 Noviembre | 5 | 7 | 12 |
| 2013 Octubre | 6 | 13 | 19 |
| 2013 Septiembre | 4 | 12 | 16 |
| 2013 Agosto | 3 | 11 | 14 |
| 2013 Julio | 3 | 0 | 3 |
| 2009 Febrero | 464 | 0 | 464 |
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