Logo image
Back
National patterns of care for early-stage penile cancers in the United States: How is radiation and brachytherapy utilized?
Journal article   Peer reviewed

National patterns of care for early-stage penile cancers in the United States: How is radiation and brachytherapy utilized?

Ria Mulherkar, Shaakir Hasan, Rodney E. Wegner, Vivek Verma, Scott M. Glaser, Ronny Kalash, Sushil Beriwal and Zachary D. Horne
Brachytherapy, v 18(4), pp 503-509
Jul 2019
DOI: https://doi.org/10.1016/j.brachy.2019.04.007
PMID: 31126857
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Brachytherapy NCDB Penile carcinoma Radiation Underutilization
Per American Brachytherapy Society guidelines, cT1-2N0 penile cancers <4 cm in diameter are excellent candidates for curative brachytherapy. Using that criterion, we evaluated national patterns of care and predictors of use of radiation techniques using the National Cancer Database. The National Cancer Database was queried for men with cT1-2N0 penile cancers <4 cm in size. Comparative statistics for treatment modality were generated using bivariate logistic regression analysis. Among 1235 cases eligible for analysis, median age was 69 years. Median tumor size was 2.0 cm. 95.8% of men underwent surgery alone, with 91 (7.4%) undergoing radical penectomy, 673 (54.5%) partial penectomy, and 419 (33.9%) cosmesis-preserving surgical procedure. Only 4 (0.3%) men were treated with brachytherapy alone, 48 (3.9%) with external-beam radiation therapy (EBRT) alone, and 8 (0.6%) with EBRT after surgery. Surgical margins were positive in 118 (9.6%) patients, 14 of whom received adjuvant EBRT (11.9%) and two adjuvant brachytherapy (1.7%). There was no difference in demographic or clinical characteristics in groups treated with surgery vs. radiation (all p > 0.2). Age >70, lesions >2 cm, and T2 tumors were more likely to undergo non–organ-preserving therapy vs. radiation or a cosmesis-preserving procedure (all p < 0.05). The propensity-matched 5-year survival was not different between definitive radiation vs. surgery (61.6% vs. 62.2%, p = 0.70). Men with penile-preserving eligible lesions in the United States are overwhelmingly treated with surgery. Penile-preserving radiation techniques including brachytherapy and EBRT are underutilized and should be offered as curative interventions.

Metrics

16 Record Views
11 citations in Web of Science
11 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
Radiology, Nuclear Medicine & Medical Imaging
Logo image