Comparing T2-T3 staging of penile cancer according to the American Joint Committee on cancer 8th edition with two modified staging systems in predicting survival outcome: A single-center experience

Shitangsu Kakoti; Sanjoy Kumar Sureka; Abhishek Pathak; Utsav Shailesh Shah; Navneet Mishra; K M Puneeth Kumar; Aneesh Srivastava; Uday Pratap Singh

doi:10.4103/iju.iju_162_22

Comparing T2-T3 staging of penile cancer according to the American Joint Committee on cancer 8^th edition with two modified staging systems in predicting survival outcome: A single-center experience

Indian J Urol. 2023 Jan-Mar;39(1):53-57. doi: 10.4103/iju.iju_162_22. Epub 2022 Dec 29.

Authors

Shitangsu Kakoti¹, Sanjoy Kumar Sureka², Abhishek Pathak², Utsav Shailesh Shah², Navneet Mishra², K M Puneeth Kumar², Aneesh Srivastava², Uday Pratap Singh²

Affiliations

¹ Department of Urology, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India.
² Department of Urology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Abstract

Introduction: Penile cancer is a rare malignancy of the genitourinary tract. We aimed to validate the recent changes in the T2 and T3 stages of penile cancer in the American Joint Committee on Cancer (AJCC) 8^th edition and to compare its predictive ability with two other modified staging systems for survival outcomes.

Methods: This is a retrospective study of patients diagnosed with penile cancer from June 2015 to March 2020. The AJCC 8^th edition and two other newly proposed systems by Li et al. and Sali et al. were used for staging the tumor. All variables were categorized and correlated with lymph node (LN) metastases and overall survival (OS).

Results: Fifty-four patients were eligible for this study. The mean age was 58 years (range 46-72 years). The tumor stage (P = 0.016), clinical LN stage (P = 0.001), the involvement of the spongiosa (P = 0.015) and the cavernosa (P = 0.002), lymphovascular invasion (LVI) (P = 0.000), and PNI (P = 0.021) were found to be the significant predictors of LN metastases. When the 5 year OS was compared between the T2 and T3 stages of the AJCC 8^th edition, Li staging and the Sali staging systems, it was 91% and 50.1% (P = 0.001), 97.5% and 10.3% (P = 0.000), 94.4% and 14.7% (P = 0.000), respectively. The presence of LVI (P = 0.001) was the most significant independent predictor of OS.

Conclusions: The recent changes in the AJCC 8^th edition pertaining to the T2-T3 stage are relevant, although the other two newly proposed staging systems were more precise in predicting the survival outcomes.