Prediction of Prognosis for Prostatic Adenocarcinoma by Combined Histological Grading and Clinical Staging

One hundred cases were studied in detail using lymphangiograms (LAG), anatomic dissections, and/or microscopic evaluation. LAG performed via the dorsal lymphatics of the penis demonstrate the existence of specific lymph node center, the so-called sentinel lymph node (SLN). This appears to be the primary site of metastases from penile carcinoma. The SLN is visualized radiographically, on the antero-posterior view, at the junction of the femoral head and the ascending ramus of the pubis. Anatomically, the SLN is part of the lymphatic system around the superficial epigastric vein. Forty-six SLN biopsies were performed with 15 positive for metastatic disease. In these 15 patients, an inguinofemoroiliac dissection was performed; in 12 cases there was no involvement of other lymph nodes. Lymphatic channels draining into the iliac lymph nodes without first draining into the sentinel lymph node were never demonstrated, nor were the inguinal-femoral lymph nodes involved in the absence of SLN involvement. On this bases, we recommend preliminary bilateral SLN biopsy to be followed by inguinofemoroiliac dissection when biopsy of the SLN biopsy to be followed by inguinofemoroiliac dissection when biopsy of the SLN is positive. When biopsy of the SLN is negative for metastatic disease, no further surgical therapy is immediately indicated. With negative SLN, 5-year survival was 90%. When SLN alone was involved, 5-year survival was 70%. Five-year survival was 50% with both SLN and other inguinal nodes involved. When iliac metastases were also present, 3-year survival was 20%.

An approach for the treatment of penile carcinoma

The view that common warts (verrucae vulgares), juvenile warts (verrucae planae), and genital warts (condylomata acuminata) are caused by the same virus and that differences in appearance are the result of variations in location and host reactivity has been shared by dermatologists for several decades (Frey, 1924; Waelsch and Habermann, 1924; Young, 1964; Rowson and Mahy, 1967; Nasemann, 1974; Lever and Schaumburg-Lever, 1975). This has probably reduced the interest in specific types of human papillomas.

Human papillomaviruses and their possible role in squamous cell carcinomas.

Patient-re ported complications and follow-up treatment after radical prostatectomy

Objective. —To learn about the natural history of untreated, early-stage prostatic cancer. Design. —Cohort study with a mean follow-up of 123 months (range, 81 to 165 months). Setting. —Population-based, regionally well defined. Patients. —A consecutive sample of 223 patients (98% of all eligible) with earlystage (T0-2, NX, MO), initially untreated prostatic cancer. Main Outcome Measures. —Progression-free, disease-specific, and overall survival. Need for palliative and terminal care. Intervention. —Patients with tumor progression were hormonally treated (orchiectomy or estrogens) if they had symptoms. Results. —After complete follow-up, only 19 (8.5%) of the 223 patients had died of prostate cancer and 105 (85%) of a total of 124 deaths were from other causes. The 10-year, disease-specific survival rate was 86.8% (95% confidence interval, 80.7% to 92.9%) and was equally high (87.9%) in a subgroup of 58 patients who met current indications for radical prostatectomy. The progression-free, 10-year survival rate was 53.1% (95% confidence interval, 44.2% to 62.0%). In 50 of 76 patients, local growth provided the only evidence of progression, and endocrine treatment was generally successful in these cases. Following an initial increase, the rate of disease progression and death from prostate cancer decreased during the last years of follow-up. Conclusion. —The low disease-specific mortality rate, especially in patients with highly and moderately differentiated tumors, means that any local or systemic therapy intended for patients with early prostatic cancer must be evaluated in clinical trials with untreated controls for comparison. ( JAMA . 1992;267:2191-2196)

High 10-year survival rate in patients with early, untreated prostatic cancer.

The Plight of the Patient with Carcinoma in Situ of the Bladder

Carcinoma of the prostate: a 15-year followup.

Carcinoma of the penis: a clinicopathologic study.

Extragonadal Testicular Tumors

The prognosis for lymphoma clinically localized to the testis at the time of original diagnosis is relatively favorable after orchiectomy and radiation therapy to the regional lymph nodes the previously held belief that life expectancy is poor for men with testicular lymphoma was due to failure in most reports to separate survival of those with localized tumor from that of patients with disseminated involvement at the time of orchiectomy. Histopathologically, all tumors were immature types, and all of the known 5-year survivors had reticulum cell lymphoma in contrast to germ cell tumors, lymphoma of the testis occurs in an older age group, has no special propensity to develop in cryptorchid testes, is more frequently bilateral, and tends to involve the skin and nasopharynx when dissemination occurs.

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%28197010%2926%3A4%3C847%3A%3AAID-CNCR2820260418%3E3.0.CO%3B2-6

David C. Utz

Papers

The Plight of the Patient with Carcinoma in Situ of the Bladder

Carcinoma of the prostate: a 15-year followup.

Carcinoma of the penis: a clinicopathologic study.

Extragonadal Testicular Tumors

Lymphoma of the testis.