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Peter Pietrzak

Publications and source records attributed to Peter Pietrzak.

5 recordsLinked to original sources

Is the association between balanitis xerotica obliterans and penile carcinoma underestimated?

OBJECTIVE: To determine the incidence of balanitis xerotica obliterans (BXO) in a consecutive series of penile carcinomas in one centre, as BXO is a common penile disease that usually involves the prepuce and glans, and there have been sporadic case reports of the association between BXO and penile carcinoma, although it is uncertain if there is a specific causal relationship. PATIENTS AND METHODS: The reported incidence of penile carcinoma in patients with BXO is 2.6-5.8%, leading some to advocate circumcision in all cases, with close follow-up in those with persistent glanular disease. We prospectively analysed all cases of penile cancer referred to the unit over a 54-month period, to determine the prevalence of BXO. RESULTS: In all, 155 patients with penile malignancy were reviewed, 44 of whom had BXO (28%). This group included 34 men with squamous cell carcinoma and 10 with carcinoma in situ; in 39, BXO and malignancy presented synchronously. In three other cases, cancer occurred in the background of chronic persistent BXO; in two cases penile cancer was truly metachronous. The tumours with associated BXO tended to be of lower stage and grade, and the patients presented when younger, but this was not statistically significant. CONCLUSION: A significant proportion of patients with penile malignancy have a histological diagnosis of BXO. We think that patients presenting with long-standing BXO and those in whom BXO has not resolved after circumcision warrant biopsies and a careful follow-up.

Adult↗

Organ-sparing surgery for invasive penile cancer: early follow-up data.

OBJECTIVE: To present early outcome data from patients treated for invasive penile cancers with organ-sparing surgery, as the treatment of such malignancies has traditionally either been amputative surgery or radical radiotherapy, both associated with significant physical and psychosexual morbidity. PATIENTS AND METHODS: A consecutive series of patients referred over a 3-year period for the treatment of penile malignancy were analysed prospectively. After clinical staging and grading, those patients requiring surgery were offered either a glans-preserving or a glans-removing procedure. RESULTS: Of the 78 patients referred, 49 required surgery, with penile-preserving procedures in 39 of them; 32 were newly diagnosed tumours and seven were recurrences after radiotherapy. The tumour grade and stage were G1 in 11, G2 in 17 and G3 in 10 (one had melanoma and was not graded); and Ta in two, T1 in 19, T2 in 17 and T3 in one. The mean follow-up was 16 months, with nine patients followed for > or = 2 years. Complications included two patients who required immediate revisional surgery for positive resection margins, and one with radio-necrosis. One patient who had a glans-preserving procedure developed a recurrence, whereas none of those who had the glans removed did so. CONCLUSION: With careful patient selection and meticulous follow-up, most patients with invasive penile carcinoma can be offered penile-preserving surgery.

Adult↗