MP10-16 18F-FDG PET/CT AS A PREDICTOR OF INVASIVENESS IN PENILE CANCER PATIENTS: CORRELATION WITH PATHOLOGY

You have accessJournal of UrologyPenis/Testis: Benign & Malignant Disease II1 Apr 2014MP10-16 18F-FDG PET/CT AS A PREDICTOR OF INVASIVENESS IN PENILE CANCER PATIENTS: CORRELATION WITH PATHOLOGY Andre Salazar, Carlos Corradi, Wadson Miconi, Walter Cabral, Lucas Nogueira, Gustavo Bretas, Marcelo Viana, and Marcelo Mamede Andre SalazarAndre Salazar More articles by this author , Carlos CorradiCarlos Corradi More articles by this author , Wadson MiconiWadson Miconi More articles by this author , Walter CabralWalter Cabral More articles by this author , Lucas NogueiraLucas Nogueira More articles by this author , Gustavo BretasGustavo Bretas More articles by this author , Marcelo VianaMarcelo Viana More articles by this author , and Marcelo MamedeMarcelo Mamede More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.472AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The penile cancer (PC) is an aggressive disease and a rare neoplasm with a low incidence in developed countries. The main prognostic factor in patients with PC is the presence of lymph node involvement. At diagnosis 28-64% of patients have clinically palpable nodes, 47-85% are lymph node metastases and the remaining inflammatory. Occult metastasis can occur in 12-24% of patients with negative lymph nodes (LN). 18F-FDG PET/CT (PET) has been used as an interesting tool to increase the efficiency of diagnosis. Previous studies have shown great performance of PET in the detection of positive nodes, with up to 86.3% accuracy in patients with cN0. This study aimed to evaluate the status of the inguinal lymph nodes, the main prognostic factor in invasive squamous cell carcinoma of the penis, with picture 18F-FDG PET / CT. METHODS A group of 29 patients (mean 58 y.o.) with squamous cell carcinoma (SCC) of the penis were prospectively included from our institution. Lymph node status was assessed preoperatively using PET and clinical evaluation (cN). After initial assessment patients underwent penectomy and lymphadenectomy was done according to PET-CT evaluation and histopathology of the tumor. All tumor and lymph node specimens were analyzed by the same pathologist with experience in uro-oncology. All PET-CT images were analyzed by the same nuclear physician with large experience. Statistical analysis was done in SPSS v.12 (IBM Corp.). RESULTS Of the 29 patients studied 34% had tumors cT2-3, majority in the glans and 48% were cN positive (cN+). Most patients underwent partial penectomy (83%), with 100% SCC, 72% well differentiated and 52% pT2-3. The cN+ showed higher tumor SUVmax (mean 13.58) (p<0.05). By using tumor SUVmax, PET images showed higher uptake for those with cavernous bodies (p <0.01) and lymph vascular (p<0.05) invations. Fourteen patients underwent inguinal lymphadenectomy, average of 13 LNs dissected, with positive LN (pN+) in 36% (mean 5 dissected positive nodes). pLN+ patients had higher SUVmax (mean 6.8) (p<0.05). ROC analysis for pLN(+) revealed an SUVmax cut-off point of 3.6, which could differentiate patients with pLN(+) with 100% sensitivity and 78% specificity (AUC=0.83). CONCLUSIONS 18F-FDG PET/CT is a useful staging examination tool for invasive PC. 18F-FDG PET/CT seems to predict inguinal lymph node invasion and the subclinical aggressiveness of the penile cancer. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e120 Advertisement Copyright & Permissions© 2014Metrics Author Information Andre Salazar More articles by this author Carlos Corradi More articles by this author Wadson Miconi More articles by this author Walter Cabral More articles by this author Lucas Nogueira More articles by this author Gustavo Bretas More articles by this author Marcelo Viana More articles by this author Marcelo Mamede More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...