Long-term evaluation of local cancer recurrence rate in a large multi-centre cohort of penile cancer patients undergoing intraoperative frozen section during organ sparing surgery
BAUS ePoster online library. Grice P. 06/24/19; 259528; P4-13
Mr. Peter Grice
Mr. Peter Grice
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Abstract
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INTRODUCTION: Local recurrence rate of penile cancer following surgical excision is reported to be 6-29%. Intraoperative Frozen Section (FS) is a tool used to ensure safe microscopic margins in organ-sparing procedures in penile cancer. We evaluated the impact of intraoperative surgical margin assessment by FS during penile-cancer preserving surgery on the local recurrence rate.

Patients and Methods:

We analysed all patients in which intraoperative FS was used during penile preserving surgery in three tertiary referral centres from 2003-2016. Urethral margin and corporal or glandular tissue proximal to the resection margin were analysed. Median follow-up was 45 (25-147) months, and only patients whose procedure was performed greater than two years previously were included to ensure adequate follow-up time.

RESULTS:
Out of 176 patients, 79 (44.9%) had partial penectomy, 73 (41.5%) total glansectomy, 9 (5.1%) wide local excision, 8 (4.5%) glans-resurfacing, 6 (3.4%) partial glansectomy, and 1 (0.6%) had circumcision. Intraoperative FS histology of the surgical margin was positive in 20 (11.4%) cases mandating further resection under the same anaesthetic. Final paraffin histology confirmed cancer-free margins in all but 2 (98.9%) patients. In total, 10 (5.7%) patients developed recurrence with a median time to recurrence of 11 months. 9 of those had negative intraoperative FS which was confirmed on paraffin section analysis.

Conclusions:
The use of intra-operative frozen section analysis during organ preserving surgery for penile cancer facilitates conservative surgery, reduces the need, distress and expense of further surgery and in this series, contributes to a low rate of local recurrence.

INTRODUCTION: Local recurrence rate of penile cancer following surgical excision is reported to be 6-29%. Intraoperative Frozen Section (FS) is a tool used to ensure safe microscopic margins in organ-sparing procedures in penile cancer. We evaluated the impact of intraoperative surgical margin assessment by FS during penile-cancer preserving surgery on the local recurrence rate.

Patients and Methods:

We analysed all patients in which intraoperative FS was used during penile preserving surgery in three tertiary referral centres from 2003-2016. Urethral margin and corporal or glandular tissue proximal to the resection margin were analysed. Median follow-up was 45 (25-147) months, and only patients whose procedure was performed greater than two years previously were included to ensure adequate follow-up time.

RESULTS:
Out of 176 patients, 79 (44.9%) had partial penectomy, 73 (41.5%) total glansectomy, 9 (5.1%) wide local excision, 8 (4.5%) glans-resurfacing, 6 (3.4%) partial glansectomy, and 1 (0.6%) had circumcision. Intraoperative FS histology of the surgical margin was positive in 20 (11.4%) cases mandating further resection under the same anaesthetic. Final paraffin histology confirmed cancer-free margins in all but 2 (98.9%) patients. In total, 10 (5.7%) patients developed recurrence with a median time to recurrence of 11 months. 9 of those had negative intraoperative FS which was confirmed on paraffin section analysis.

Conclusions:
The use of intra-operative frozen section analysis during organ preserving surgery for penile cancer facilitates conservative surgery, reduces the need, distress and expense of further surgery and in this series, contributes to a low rate of local recurrence.

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