title: Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis.
abstract: OBJECTIVE
  Penile squamous cell carcinoma (SCC) is a rare entity, with few published series on outcomes. We evaluated the stage distributions and outcomes for surgery and radiation therapy in a U.S. population database.
  
  
  METHODS
  Subjects with SCC of the penis were identified using the National Cancer Institute Surveillance, Epidemiology and End Results (SEER) Program database between 1988 and 2006. Descriptive statistics were performed, and cause-specific survival (CSS) was estimated using Kaplan-Meier analysis. Comparisons of treatment modalities were analyzed using multivariate Cox regression. Subjects were staged using American Joint Committee on Cancer, sixth edition, criteria.
  
  
  RESULTS
  There were 2458 subjects identified. The median age was 66.8 years (range, 17-102 years). Grade 2 disease was present in 94.5% of cases. T1, T2, T3, T4, and Tx disease was present in 64.8%, 17.1%, 9.5%, 2.1%, and 6.5% of cases, respectively. N0, N1, N2, N3, and Nx disease was noted in 61.6%, 6.9%, 4.0%, 3.7%, and 23.8% of cases, respectively. M1 disease was noted in 2.5% of subjects. Individuals of white ethnicity accounted for 85.1% of cases. Lymphadenectomy was performed in 16.7% of cases. The CSS for all patients at 5 and 10 years was 80.8% and 78.6%. By multivariable analysis grades 2 and 3 disease, T3 stage, and positive lymph nodes were adverse prognostic factors for CSS.
  
  
  CONCLUSIONS
  SCC of the penis often presents as early-stage T1, N0, M0, grade 1, or grade 2 disease. The majority of patients identified were treated with surgery, and only a small fraction of patients received radiation therapy alone or as adjuvant therapy.
authors.affiliation: Radiation Oncology Department, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Burt
authors.affiliation: Radiation Oncology Department, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Shrieve
authors.affiliation: Radiation Oncology Department, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah. Electronic address: Jonathan.Tward@hci.utah.edu.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Tward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging / Q000379:methods*; D059351:Organ Sparing Treatments; D010412:Penile Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D010413:Penis / Q000601:surgery; D011379:Prognosis; D012044:Regression Analysis; D018426:SEER Program; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult