Oncologic Outcomes of Penile Cancer Treatment at a UK Supraregional Center

Abstract

Objective: To report contemporary treatment outcomes of penile squamous cell carcinoma at a UK supraregional center, including patterns of therapy, oncologic results, and long-term survival.

Patients and methods: Patients with squamous cell carcinoma treated during the period January 2000 to January 2011 were included. Records were reviewed to identify the mode of therapy (penile preserving or amputative surgery), pathology reports (reclassified according to the 2009 tumor-nodes-metastasis classification), recurrence patterns, and cancer-specific survival (CSS). Kaplan-Meier plots were used for survival analyses.

Results: Two hundred three patients were identified with a median follow-up of 61 months. At presentation, 165 patients (82%) were node negative, 31 (15%) were node positive, and 7 (3%) had metastatic disease. Management was penile preserving surgery (n = 99, 49%), partial penectomy (n = 49, 24%), radical penectomy (n = 48, 24%), and chemotherapy or radiotherapy for metastatic disease (n = 7, 3%). After organ-preserving surgery, the local recurrence rate was 18% (compared with 4% for amputative surgery), with 94% of recurrences occurring within 3 years. Histopathologic staging was as follows, with pTis (20%), pT1 (27%), pT2 (27%), pT3 (7%), and pT4 (1%). Kaplan-Meier analysis showed a 5-year CSS of 85% and a 10-year CSS of 81%. Five-year CSS was noted to decrease with advancing stage with pN0 tumors (92%), N1 (73%), N2 (61%), N3 (33%), and M1 (0%; P <.0001).

Conclusion: Supraregional penile cancer management has led to considerable clinical experience in our center over the past decade. Close follow-up is vital to pick up local recurrence after penile-preserving surgery. Overall oncologic outcomes are good with a 5-year CSS of 85%.