Is sarcopenia a useful prognostic indicator in patients with squamous cell carcinoma of the penis?

426 Background: Sarcopenia is a decrease in skeletal muscle mass and is a quantifiable marker of frailty associated with poor oncological outcomes. Currently there are no studies using sarcopenia as a prognostic indicator for patients with penile cancer. This study investigated the association of sarcopenia with mortality and morbidity outcomes in penile cancer patients in a specialist centre. Methods: A retrospective case-controlled study was performed. Patient cohort comprised 50 patients with metastatic penile cancer ( > pN2 disease) and 50 patients with non-metastatic disease (N0) ; minimum follow-up period of 2 years. Sarcopenia was classified as a skeletal muscle index < 55cm2/m2 and was measured using software and CT imaging. Results: Sarcopenia was present in 31% of our cohort (n = 100). A univariate analysis showed a statistically significant association between the following parameters and patient mortality; sarcopenia (p = 0.005), metastatic disease (p = 0.001), tumour stage (p = 0.001), sarcomatoid squamous cell carcinoma (p = 0.009), CIS (p = 0.034), lymphovascular invasion (LVI) (p = 0.001) and perineural invasion (p = 0.002). Logistic regression analysis found an association between mortality and sarcopenia (p = 0.035) and metastatic disease (p = 0.000) and approached statistical significance with LVI (p = 0.061). Subdividing our cohort into metastatic and non-metastatic groups, showed that sarcopenia was associated with mortality in patients with metastatic disease but was not associated with post-operative complications or chemo-radiotherapy toxicity. Interestingly, sarcopenia was associated with post-operative infection in patients undergoing surgery for non-metastatic disease (p = 0.027). Additionally, for every day remaining in hospital after the 4th post-operative day, there was a 1.275 increase in the risk of death in patients with sarcopenia. Conclusions: Sarcopenia has a potential role as a novel prognostic indicator and could be used as a risk stratification tool in patients with metastatic penile cancer when deciding treatment options. By identifying this subgroup, additional nutritional support and a supervised exercise program can be implemented to improve the morbidity rate.

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Penile squamous cell carcinoma :a three-year study at BP Koirala Memorial Cancer Hospital

Medical Journal of Pokhara Academy of Health Sciences ◽

10.3126/mjpahs.v2i3.26110 ◽

2019 ◽

Vol 2 (3) ◽

pp. 149-153

Author(s):

Shankar Bastakoti ◽

Ranjan Raj Bhatta ◽

Nandita Jha ◽

Sadina Shrestha ◽

Amrita Paudel

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Penile Cancer ◽

The Elderly ◽

Prognostic Indicator ◽

Study Data ◽

Cancer Hospital ◽

Well Differentiated ◽

Penile Squamous Cell Carcinoma

Background: Penile cancer is an aggressive and mutilating disease which deeply affects self-esteem and daily life of the patient. Penile cancer mostly affects the elderly, seen in people in their sixties and seventies. Occurrence in younger age is a need of research of penile neoplasia in young non-circumcised patients. Materials and Method: This is a three-year retrospective study. Data was extracted from the Department of Pathology and Medical Record section of B.P. Koirala Memorial Cancer Hospital. All histologically proven cases were included. The objective of this study was to assess clinical histopathological profile of penile carcinoma. Results. A total of 114 malignant cases were included out of which most common age group involved was 50-60 years with mean age of presentation being 51.6 years. Glans was the commonest site of involvement in 59 cases (51.7%). Well-differentiated squamous cell carcinoma was the most common type (71%). Forty nine patients (43%) presented when the mass size was 4-6 cm and 44 (39%) came with 2-4cm and rest less than 2 cm. Lymphvascular invasion was seen in 15 (13%) out of 114 cases and perineural invasion was seen only in 5 (4.3%) cases. 20 cases (17.5%) had lymphnodes positive which are less than 5 lymphnode positive and five (4.3%) had more than 5 lymphnodes positive. Conclusion. Early diagnosis and intervention of the patient ensure high probability of getting cured because the stage at presentation appears to be the most vital prognostic indicator for survival.

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Outcomes of multidisciplinary treatment in penile cancer: Experience from Thailand.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.555 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 555-555

Author(s):

Wichien Sirithanaphol ◽

Kachit Pachirat ◽

Ukrit Rompsaithong ◽

Pakorn Kiatsopit ◽

Supanut Lumbiganon ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Squamous Cell ◽

Survival Data ◽

Penile Cancer ◽

Multidisciplinary Treatment ◽

Locally Advanced ◽

P Value

555 Background: Penile cancer is relatively more common in Thailand compared to western countries. We report multidisciplinary treatment outcomes of penile squamous cell carcinoma at a regional center in northeast of Thailand. Methods: Using an institutional database, a total of 68 patients with squamous cell carcinoma of penis treated during 2009-2015 were identified. Patient demographics, pathological data, and treatment modality were reviewed. Survival data was calculated using the Kaplan-Meier method. Results: Median age was 53 years (25-89 years) and the median follow-time was 2.7 years. At presentation, 39 patients (57.4%) were node positive, and 9 (13.2%) had metastatic disease. Management was penile preserving surgery in 13 patients, partial penectomy in 36 patients, total penectomy in 15 patients, and palliative with radiation and/or chemotherapy in 4 patients. The 3-year overall survival for patients with N0-1 and N2-3 was 86% and 35% respectively. For those with high risk (N2/N3) non-metastatic disease, multimodality treatment improved overall survival significantly compared with surgery alone (13.7 mo vs 8.6 mo; HR 0.32, p-value = 0.04) Conclusions: Patients present with locally advanced disease had a poor prognosis. Multidisciplinary management improved overall survival N2/N3 patients.

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Long-term survival in patients with metastatic head and neck squamous cell carcinoma treated with metastasis-directed therapy

British Journal of Cancer ◽

10.1038/s41416-019-0601-8 ◽

2019 ◽

Vol 121 (11) ◽

pp. 897-903 ◽

Cited By ~ 5

Author(s):

Thomas H. Beckham ◽

Jonathan E. Leeman ◽

Peng Xie ◽

Xiaolin Li ◽

Debra A. Goldman ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Metastatic Disease ◽

Squamous Cell ◽

Disease Burden ◽

Neck Squamous Cell Carcinoma ◽

Risk Of Death ◽

Definitive Therapy ◽

Limited Metastatic Disease

Abstract Background Our objective was to evaluate the outcomes of metastatic head and neck squamous cell carcinoma (HNSCC) by disease burden with an emphasis on metastasis-directed therapy (MDT) in patients with limited metastatic disease burden. Methods In total, 186 patients who developed metastatic disease after definitive therapy for HNSCC were included. Clinically and radiographically apparent metastases were enumerated. Kaplan–Meier methods were used to estimate survival. Cox regression was used to assess the association between clinical variables. Results Patients with a single metastasis had a 5-year overall survival (OS) of 35% (95% CI 16–54%) in contrast to patients with multiple metastases with a 5-year OS of 4% (95% CI 2–9%). Thirty patients (16.1%) underwent MDT. On multivariable analysis, oral cavity or sinonasal primary (HR 2.22 95% CI 1.16–4.25, p = 0.015; HR 4.88, 95% CI 1.10–21.70, p = 0.037, respectively) were associated with higher risk of death, whereas receipt of MDT (HR 0.36, 95% CI 0.17–0.74, p = 0.006) was associated with lower hazard of death. Median subsequent metastasis-free survival and 5-year survival after MDT (n = 30) were estimated at 26.4 months (95% CI: 9.8–54.0) and 31%, (95% CI: 15–48%). Conclusions HNSCC patients with limited metastatic disease may derive significant benefit from MDT. Prospective trials evaluating MDT in HNSCC are warranted.

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ATYPICAL PRESENTATION OF STAGE IV BUCCAL SQUAMOUS CELL CARCINOMA WITH METASTATIC DISEASE TO MYOCARDIUM

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)03816-x ◽

2021 ◽

Vol 77 (18) ◽

pp. 2461

Author(s):

Michael Lee ◽

Vinisha Garg

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Squamous Cell ◽

Stage Iv ◽

Atypical Presentation ◽

Buccal Squamous Cell Carcinoma

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The REASON score: an epigenetic and clinicopathologic score to predict risk of poor survival in patients with early stage oral squamous cell carcinoma

Biomarker Research ◽

10.1186/s40364-021-00292-x ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Chi T. Viet ◽

Gary Yu ◽

Kesava Asam ◽

Carissa M. Thomas ◽

Angela J. Yoon ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Risk Score ◽

Squamous Cell ◽

Early Stage ◽

Genome Wide Association Studies ◽

Gene Methylation ◽

Poor Survival ◽

Risk Of Death

Abstract Background Oral squamous cell carcinoma (OSCC) is a capricious cancer with poor survival rates, even for early-stage patients. There is a pressing need to develop more precise risk assessment methods to appropriately tailor clinical treatment. Genome-wide association studies have not produced a viable biomarker. However, these studies are limited by using heterogeneous cohorts, not focusing on methylation although OSCC is a heavily epigenetically-regulated cancer, and not combining molecular data with clinicopathologic data for risk prediction. In this study we focused on early-stage (I/II) OSCC and created a risk score called the REASON score, which combines clinicopathologic characteristics with a 12-gene methylation signature, to predict the risk of 5-year mortality. Methods We combined data from an internal cohort (n = 515) and The Cancer Genome Atlas (TCGA) cohort (n = 58). We collected clinicopathologic data from both cohorts to derive the non-molecular portion of the REASON score. We then analyzed the TCGA cohort DNA methylation data to derive the molecular portion of the risk score. Results 5-year disease specific survival was 63% for the internal cohort and 86% for the TCGA cohort. The clinicopathologic features with the highest predictive ability among the two the cohorts were age, race, sex, tobacco use, alcohol use, histologic grade, stage, perineural invasion (PNI), lymphovascular invasion (LVI), and margin status. This panel of 10 non-molecular features predicted 5-year mortality risk with a concordance (c)-index = 0.67. Our molecular panel consisted of a 12-gene methylation signature (i.e., HORMAD2, MYLK, GPR133, SOX8, TRPA1, ABCA2, HGFAC, MCPH1, WDR86, CACNA1H, RNF216, CCNJL), which had the most significant differential methylation between patients who survived vs. died by 5 years. All 12 genes have already been linked to survival in other cancers. Of the genes, only SOX8 was previously associated with OSCC; our study was the first to link the remaining 11 genes to OSCC survival. The combined molecular and non-molecular panel formed the REASON score, which predicted risk of death with a c-index = 0.915. Conclusions The REASON score is a promising biomarker to predict risk of mortality in early-stage OSCC patients. Validation of the REASON score in a larger independent cohort is warranted.

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Comparison of Androgen Receptor, VEGF, HIF-1, Ki67 and MMP9 Expression between Non-Metastatic and Metastatic Stages in Stromal and Tumor Cells of Oral Squamous Cell Carcinoma

Life ◽

10.3390/life11040336 ◽

2021 ◽

Vol 11 (4) ◽

pp. 336

Author(s):

Lovorka Batelja-Vuletic ◽

Cedna Tomasovic-Loncaric ◽

Marcello Ceppi ◽

Marco Bruzzone ◽

Aleksandra Fucic ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Squamous Cell ◽

Mmp9 Expression ◽

Oral Malignancy ◽

First Time ◽

Epithelium Cells ◽

Diagnostics And Therapy

Objectives: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy with low survival as it is very often diagnosed at an advanced stage, which is why the accurate profiling of the tumor is essential. The aim of this study was to, for the first time, compare in OSCC the frequency of AR, VEGF, MMP9, HiF1beta and Ki67 between the non-metastatic and metastatic disease. Materials and Methods: In the study, 96 non-metastatic and 91 metastatic OSCC patients were analysed for AR, VEGF, MMP9, HiF1beta and Ki67 levels by immunohistochemistry. Results: All of the tested biomarkers significantly differed between non-metastatic and metastatic disease. A significant association was found between >/=20% AR positive epithelium cells in cytoplasm, Ki67 and VEGF in cancer stroma. Ki67, HiF1beta, VEGF and MMP9 were significantly associated with TNM stages. Conclusion: Our results show for the first time an interplay between AR, VEGF, MMP9, HiF1beta and Ki67 in OSCC which may contribute to better diagnostics and therapy selection.

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