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Das Peniskarzinom

Penile cancer

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Der Onkologe Aims and scope

Zusammenfassung

Aufgrund der geringen Inzidenz des Peniskarzinoms ist die Evidenzlage zu seiner Therapie sehr schwach. Durch die zunehmend an onkologischen Zentren erfolgende Versorgung betroffener Patienten konnten jedoch in den letzten Jahren deutliche Fortschritte in der Behandlungsqualität erzielt und neue therapeutische Ansätze entwickelt werden. Bei der operativen Therapie des frühen Primärkarzinoms steht zunehmend die Organerhaltung im Vordergrund, vorausgesetzt, die tumorfreien Schnittränder können per Schnellschnittuntersuchung gesichert werden. Entscheidend für die Prognose des Peniskarzinoms ist ein stadiengerechtes Management der inguinalen Lymphknoten. Voraussetzung für einen kurativen Therapieansatz ist die Entfernung aller metastatisch befallenen Lymphknoten. Aufgrund aktueller Studienergebnisse ist der taxan- und cisplatinhaltigen Chemotherapie der Vorzug zu geben, da mit dieser Kombination im neoadjuvanten und adjuvanten Setting die besten Ergebnisse erzielt werden konnten.

Abstract

Due to the low incidence of penile cancer, evidence regarding efficient therapeutic strategies in the existing literature is rare. The treatment of patients in oncologic referral centers has improved the establishment and quality of new therapeutic regimens. In case of small primary tumors, organ preserving surgery should be considered standard of care, providing a safe tumor-free margin zone controlled by fresh frozen section examination. The correct and thorough management of inguinal lymph node disease is of paramount importance in order to increase the chance of cure in the metastatic setting. Complete remission of penile caner can only be achieved by complete removal of all lymph nodes, including micrometastases. According to recent studies, taxane- and cisplatinum-based chemotherapy seems promising for penile cancer in the neoadjuvant and adjuvant setting. Patients should be treated in referral centers in order to obtain the best results.

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Abbreviations

CIS:

Zervikale intraepitheliale Neoplasie

CT:

Computertomographie

DNA:

Desoxyribonukleinsäure

DSNB :

Dynamische „sentinel node biopsy“

EAU :

„European Association of Urology“

EGFR :

„Epidermal growth factor receptor“

EQ:

Erythroplasie Queyrat

FU:

Fluorouracil

HE:

Hämatoxylin-Eosin

HPV:

Humanes Papillomavirus

LA:

Lymphadenektomie

LOH:

„Loss of heterozygocity“

MRT:

Magnetresonanztomographie

PDR:

„Pulsed dose rate“

PET:

Positronenemissionstomographie

PIN:

„Prostatic intraepithelial neoplasia“

pN:

Pathologische Lymphknotenklassifikation

SPECT :

„Single photon emission computed tomography“

Ta/Tis-Tumoren :

Tumoren, die die Basalmembran noch nicht infiltriert haben

TNM :

Tumor, „node“, Metastase

UICC:

„Union internationale contre le cancer“

WHO:

„World Health Organisation“

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Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 6 , 18055, Rostock, Deutschland

    C. Protzel & O.W. Hakenberg

  2. Institut für Pathologie, Universitätsmedizin Rostock, Rostock, Deutschland

    C. Kakies & A. Erbersdobler

  3. Klinik und Poliklinik für Nuklearmedizin, Universitätsmedizin Rostock, Rostock, Deutschland

    S. Schwarzenboeck & B. Krause

  4. Klinik und Poliklinik für Strahlentherapie, Universitätsmedizin Rostock, Rostock, Deutschland

    T. Kuhnt

Authors
  1. C. Protzel
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  2. C. Kakies
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  3. S. Schwarzenboeck
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  4. T. Kuhnt
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  5. A. Erbersdobler
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  6. B. Krause
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  7. O.W. Hakenberg
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Correspondence to C. Protzel.

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Protzel, C., Kakies, C., Schwarzenboeck, S. et al. Das Peniskarzinom. Onkologe 19, 149–162 (2013). https://doi.org/10.1007/s00761-012-2421-9

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  • DOI: https://doi.org/10.1007/s00761-012-2421-9

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