Primary penile mucosal melanoma: a case series from UK tertiary referral centre
BAUS ePoster online library. Pozzi E. 06/21/21; 319087; p4-9
Disclosure(s): Nothing to disclose.
Dr. Edoardo Pozzi
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INTRODUCTION - We aimed to review and compare the management and outcomes for men with penile mucosal melanoma treated in a UK tertiary referral centre.
METHODS – A single centre retrospective study identified patients treated for penile mucosal melanoma over a 10 year-period. Patients were managed according to modified EAU Penile Cancer guidelines for SCC. . Grading, Breslow's thickness, Clark's staging, number of mitoses, ulceration, lymph node involvement, distant metastasis, local/distant recurrence (LR), LVI, PNI, immunohistochemistry (S100, HMB-45, Melan-A, BRAF, NRAS, Ki-67 and c-kit), type of primary surgery, post-operative complications and adjuvant treatments were evaluated.
RESULTS – Ten patients were included in the study. Median follow up (IQR) was 17 (7-33) months. Cancer specific survival (CSS) at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0% respectively. 6 patients died of penile melanoma. 4 developed LR in 5 months from primary diagnosis. 3 patients with palpable inguinal lymphadenopathy at first assessment underwent radical inguinal lymphadenectomy. In 2 patients dynamic sentinel lymph node biopsy (DSNB) was negative. All patients with metastatic disease and/or groin lymph node invasion died within 25 months from primary diagnosis. Molecular testing, penile preserving surgery and brain MRI was offered to all patients. Adjuvant treatment was offered to 4 patients.
CONCLUSION – The current series confirms that the prognosis is poor. The EAU guidelines follow the same recommendations for surgery although the mucosal melanoma guidelines provide additional guidance for molecular testing/staging and management of inguinal lymph nodes as well as novel systemic treatment.
METHODS – A single centre retrospective study identified patients treated for penile mucosal melanoma over a 10 year-period. Patients were managed according to modified EAU Penile Cancer guidelines for SCC. . Grading, Breslow's thickness, Clark's staging, number of mitoses, ulceration, lymph node involvement, distant metastasis, local/distant recurrence (LR), LVI, PNI, immunohistochemistry (S100, HMB-45, Melan-A, BRAF, NRAS, Ki-67 and c-kit), type of primary surgery, post-operative complications and adjuvant treatments were evaluated.
RESULTS – Ten patients were included in the study. Median follow up (IQR) was 17 (7-33) months. Cancer specific survival (CSS) at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0% respectively. 6 patients died of penile melanoma. 4 developed LR in 5 months from primary diagnosis. 3 patients with palpable inguinal lymphadenopathy at first assessment underwent radical inguinal lymphadenectomy. In 2 patients dynamic sentinel lymph node biopsy (DSNB) was negative. All patients with metastatic disease and/or groin lymph node invasion died within 25 months from primary diagnosis. Molecular testing, penile preserving surgery and brain MRI was offered to all patients. Adjuvant treatment was offered to 4 patients.
CONCLUSION – The current series confirms that the prognosis is poor. The EAU guidelines follow the same recommendations for surgery although the mucosal melanoma guidelines provide additional guidance for molecular testing/staging and management of inguinal lymph nodes as well as novel systemic treatment.
INTRODUCTION - We aimed to review and compare the management and outcomes for men with penile mucosal melanoma treated in a UK tertiary referral centre.
METHODS – A single centre retrospective study identified patients treated for penile mucosal melanoma over a 10 year-period. Patients were managed according to modified EAU Penile Cancer guidelines for SCC. . Grading, Breslow's thickness, Clark's staging, number of mitoses, ulceration, lymph node involvement, distant metastasis, local/distant recurrence (LR), LVI, PNI, immunohistochemistry (S100, HMB-45, Melan-A, BRAF, NRAS, Ki-67 and c-kit), type of primary surgery, post-operative complications and adjuvant treatments were evaluated.
RESULTS – Ten patients were included in the study. Median follow up (IQR) was 17 (7-33) months. Cancer specific survival (CSS) at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0% respectively. 6 patients died of penile melanoma. 4 developed LR in 5 months from primary diagnosis. 3 patients with palpable inguinal lymphadenopathy at first assessment underwent radical inguinal lymphadenectomy. In 2 patients dynamic sentinel lymph node biopsy (DSNB) was negative. All patients with metastatic disease and/or groin lymph node invasion died within 25 months from primary diagnosis. Molecular testing, penile preserving surgery and brain MRI was offered to all patients. Adjuvant treatment was offered to 4 patients.
CONCLUSION – The current series confirms that the prognosis is poor. The EAU guidelines follow the same recommendations for surgery although the mucosal melanoma guidelines provide additional guidance for molecular testing/staging and management of inguinal lymph nodes as well as novel systemic treatment.
METHODS – A single centre retrospective study identified patients treated for penile mucosal melanoma over a 10 year-period. Patients were managed according to modified EAU Penile Cancer guidelines for SCC. . Grading, Breslow's thickness, Clark's staging, number of mitoses, ulceration, lymph node involvement, distant metastasis, local/distant recurrence (LR), LVI, PNI, immunohistochemistry (S100, HMB-45, Melan-A, BRAF, NRAS, Ki-67 and c-kit), type of primary surgery, post-operative complications and adjuvant treatments were evaluated.
RESULTS – Ten patients were included in the study. Median follow up (IQR) was 17 (7-33) months. Cancer specific survival (CSS) at 1, 2 and 5 years after primary surgery was 33%, 16.7% and 0% respectively. 6 patients died of penile melanoma. 4 developed LR in 5 months from primary diagnosis. 3 patients with palpable inguinal lymphadenopathy at first assessment underwent radical inguinal lymphadenectomy. In 2 patients dynamic sentinel lymph node biopsy (DSNB) was negative. All patients with metastatic disease and/or groin lymph node invasion died within 25 months from primary diagnosis. Molecular testing, penile preserving surgery and brain MRI was offered to all patients. Adjuvant treatment was offered to 4 patients.
CONCLUSION – The current series confirms that the prognosis is poor. The EAU guidelines follow the same recommendations for surgery although the mucosal melanoma guidelines provide additional guidance for molecular testing/staging and management of inguinal lymph nodes as well as novel systemic treatment.
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