National Trends and Predictors of Organ-sparing for Invasive Penile Tumors: Expanding the Therapeutic Window.

Abstract

INTRODUCTION:

The purpose of this study was to analyze contemporary trends and predictors in the use of organ-sparing treatment (OST) for low-stage invasive penile tumors as well as to ascertain its impact on overall mortality (OM) in those with high-risk (pT2) disease.

PATIENTS AND METHODS:

The National Cancer Data Base was queried for patients with clinically nonmetastatic penile cancer and available pathologic tumor (pT) and treatment data from 1998 to 2012. Independent predictors for performance of OST were analyzed. Multivariable Cox proportional hazard regression was used to identify factors of OM in a subset of patients with pT2 disease.

RESULTS:

A total of 4231 patients with ≤ pT2cN0cM0 primary penile cancer were identified over a median follow-up of 39.6 months. Approximately 49% of patients received OST over the study period (P = .009). Older age, Hispanic ethnicity, urban counties, academic facilities, and pT2 disease were negative predictors for OST (all P < .05), whereas grade and years of diagnosis where associated with increased performance (P < .01). In subgroup analysis of pT2 patients, older age, black race, comorbidity, node status, and grade were associated with higher OM (all P < .05). When compared with radical penectomy, partial penectomy was associated with decreased OM (hazard ratio, 0.67; 95% confidence interval, 0.52-0.87; P = .002), whereas organ-sparing did not affect survival (hazard ratio, 0.83; 95% confidence interval, 0.52-1.31; P = .419) in these patients.

CONCLUSION:

Ethnic and socioeconomic differences exist in the local management of penile tumors. No impact on OM was observed for those with high-risk cases treated with organ-sparing at intermediate follow-up. More studies are needed to evaluate oncologic efficacy of organ-sparing in carefully selected invasive penile tumors.

• Authors: Juan Chipollini, Dominic H Tang, Pranav Sharma, Philippe E Spiess
• Journal: Clinical genitourinary cancer (Clin Genitourin Cancer) Vol. 16 Issue 2 Pg. e383-e389 (04 2018) ISSN: 1938-0682 [Electronic] United States
• PMID: 28967504 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier Inc. All rights reserved.

Topics

• Aged
• Carcinoma, Squamous Cell (ethnology, pathology, surgery)
• Databases, Factual
• Ethnicity
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Organ Sparing Treatments (methods)
• Penile Neoplasms (ethnology, pathology, surgery)
• Proportional Hazards Models
• Risk Factors
• Survival Analysis
• Treatment Outcome