title: Predictive factors for recurrence in clinically localized squamous cell carcinoma of the penis. Analisys of our case series.
abstract: OBJECTIVE
  To evaluate the predictive factors for relapse in clinically localized squamous cell carcinoma of the penis undergoing surgical treatment.
  
  
  METHODS
  Forty-nine patients were diagnosed with cancer of the penis in our Service between 1999 and 2009. In the present study we excluded 18 subjects: 9 due to the presence of palpable adenopathies, 6 due to histological characteristics other than squamous cell carcinoma, two lost to follow-up, and one due to death at the time of diagnosis. Diagnosis was based on physical examination and biopsy findings. The primary lesion was treated by circumcision, partial surgery or total penectomy. Disease relapse was defined by lymph node or metastatic involvement after three months from surgery. Univariate and multivariate analysis were carried out using the chi-squared test and logistic regression to identify the factors involved in tumor relapse.
  
  
  RESULTS
  Thirty-one patients were included in the study. Mean follow-up was 36 months (median 29). The histopathological study yielded the following profile: 55% pT1 cases, 32% pT2 cases and 13% pT3 tumors. Regarding histological grade, the distribution was G1: 29%, G2: 32%, G3: 39%. Recurrence and mortality rates were 38.7% and 35.5%, respectively. In the univariate analysis, location of the lesion (p=0.004), type of surgery (p=0.008), tumor stage (p=0.003) and cellular grade (p<0.001)were significantly correlated to disease relapse. In the multivariate analysis, only cellular grade proved statistically significant (p=0.01).
  
  
  CONCLUSIONS
  In our series, only histological grade could be regarded as an independent predictor of tumor relapse.
authors.affiliation: Urology Department, Hospital Universitario Gregorio Marañon, Madrid, Spain. robersescu@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Molina Escudero
authors.forename: F
authors.initials: F
authors.lastname: Herranz Amo
authors.forename: J
authors.initials: J
authors.lastname: Jara Rascón
authors.forename: E
authors.initials: E
authors.lastname: Lledó García
authors.forename: A
authors.initials: A
authors.lastname: Husillos Alonso
authors.forename: G
authors.initials: G
authors.lastname: Ogaya Piniés
authors.forename: C
authors.initials: C
authors.lastname: Navas Martínez
authors.forename: C
authors.initials: C
authors.lastname: Hernández Fernández
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010412:Penile Neoplasms / Q000473:pathology* / Q000601:surgery; D010413:Penis / Q000473:pathology; D011237:Predictive Value of Tests; D016019:Survival Analysis