The role of pathologic prognostic factors in squamous cell carcinoma of the penis
ABSTRACT The aim of this review was to identify prognostic pathologic factors which are independent from other clinical or molecular variables.
We reviewed the literature on morphological prognostic factors emphasizing our personal experience.
We found that for a proper evaluation of prognostic factors a familiarity with penile complex anatomy is required. A biopsy of the primary tumor is not useful for a complete evaluation of prognostic factors other than malignancy and a resected specimen should be utilized. Penile carcinomas have a fairly predictable pattern of local, regional and systemic spread. Pathologic factors affecting patients outcome are multiple but it is difficult from the available studies using heterogeneous pathologic methodologies, different therapeutic approaches and ecologically variable patient populations to ascertain the independent validity of these factors. Invasion of perineural spaces by tumor, lymphatic-venous embolization and histological grade appear to be the most important pathologic predictors of nodal spread and cancer mortality. Other commonly cited factors influencing prognosis are tumor depth or thickness, anatomical site and size of the primary tumor, patterns of growth, irregular front of invasion, pathologic subtypes of the SCC, positive margins of resection and urethral invasion. A combination of two factors, histological grade and depth has been reported as significant predictor of cancer regional spread. After a preselection of significant factors, nomograms have been constructed to collectively evaluate the predictive power of various clinical and pathological indicators.
Among various factors perineurial invasion, vascular invasion and high histological grade appear to be the most important adverse pathological prognostic factors.
- SourceAvailable from: Philippe Camparo
Progrès en Urologie 11/2010; 20. DOI:10.1016/S1166-7087(10)70044-0 · 0.77 Impact Factor
- "Les deux localisations les plus fréquentes sont le gland (48 % des cas) et le prépuce (25 % des cas). Le pronostic du carcinome épidermoide est conditionné par sa profondeur d'infiltration, son grade histopronostique et l'existence d'emboles sanguins ou lymphatiques ou périnerveux . "
- [Show abstract] [Hide abstract]
ABSTRACT: The applicability of neural networks to generate complex behaviour on autonomous systems is demonstrated both at soft- and hardware-level. In particular, the emergence of simple behaviors based on the Braitenberg approach, adaptive sensor calibration by self-organizing maps with a comparison between off- and online learning and a visualisation tool for a posteriori analysis are shown. It is also envisaged to present the working of embedded neural hardware as associative memory and self-organizing maps. In this connection, the mini-robot Khepera serves as an exemplary platformMicroelectronics for Neural, Fuzzy and Bio-Inspired Systems, 1999. MicroNeuro '99. Proceedings of the Seventh International Conference on; 02/1999
- [Show abstract] [Hide abstract]
ABSTRACT: Penile verrucous carcinoma is a rare disease and little is known of its aetiology or pathogenesis. In this study we examined cell-cycle proteins expression and correlation with human papillomavirus infection in a series of 15 pure penile verrucous carcinomas from a single centre. Of 148 penile tumours, 15 (10%) were diagnosed as pure verrucous carcinomas. The expression of the cell-cycle-associated proteins p53, p21, RB, p16(INK4A) and Ki67 were examined by immunohistochemistry. Human papillomavirus infection was determined by polymerase chain reaction to identify a wide range of virus types. The expression of p16(INK4A) and Ki67 was significantly lower in verrucous carcinoma than in usual type squamous cell carcinoma, whereas the expression of p53, p21 and RB was not significantly different. p53 showed basal expression in contrast to usual type squamous cell carcinoma. Human papillomavirus infection was present in only 3 out of 13 verrucous carcinomas. Unique low-risk, high-risk and mixed viral infections were observed in each of the three cases. In conclusion, lower levels of p16(INK4A) and Ki67 expressions differentiate penile verrucous carcinoma from usual type squamous cell carcinoma. The low Ki67 index reflects the slow-growing nature of verrucous tumours. The low level of p16(INK4A) expression and human papillomavirus detection suggests that penile verrucous carcinoma pathogenesis is unrelated to human papillomavirus infection and the oncogenes and tumour suppressor genes classically altered by virus infection.Modern Pathology 06/2009; 22(9):1160-8. DOI:10.1038/modpathol.2009.77 · 6.36 Impact Factor