title: Clinicopathologic characteristics and outcomes of penile cancer treated at tertiary care centers in the Western United States.
abstract: BACKGROUND
  This article reports on the experience with penile squamous cell carcinoma (PSCC) in a unique multiethnic patient population from Los Angeles, California, with regard to treatments rendered and clinical outcomes.
  
  
  METHODS
  Available clinical, pathologic, and treatment information for PSCC patients treated at 3 hospitals associated with the University of Southern California from 1991 to 2011 was retrospectively reviewed. Associations of patient variables with prognosis were assessed using univariable and multivariable analyses.
  
  
  RESULTS
  Of the 95 PSCC patients identified, clinicopathologic and outcome information was available on 89 men (median age, 53 years; median follow-up, 23 months). National minorities comprised 76.4% of the cohort with 57.3% Hispanics accounting for all patients. Presence of poorly differentiated tumors was associated with higher tumor stage (P = .020), nodal metastasis (P = .016), distant metastasis (P = .004), and advanced AJCC disease stage (P = .001). Univariate analysis showed that tumor (P = .008), nodal (P = .033), and metastasis (P < .001) stage, and tumor differentiation (P = .010) were associated with survival. When categorized according to the AJCC classification, patients with ≥ stage III disease had worse outcomes (P = .006). Type of primary therapy delivered did not affect outcomes. AJCC disease stage was independently prognostic in multivariable analysis (P = .035).
  
  
  CONCLUSIONS
  These results confirm associations of several clinicopathologic factors with PSCC outcomes, although the presented population differs from others previously described from the United States with a relatively higher proportion of Hispanic men. This highlights the need for studies on the effects of race, cultural, health, and behavioral patterns on PSCC outcomes in multiethnic populations.
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA.
authors.forename: Isuru S
authors.initials: IS
authors.lastname: Jayaratna
authors.affiliation: Department of Pathology and Center for Personalized Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Anirban P
authors.initials: AP
authors.lastname: Mitra
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Schwartz
authors.affiliation: Division of Medical Oncology, Department of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Tanya B
authors.initials: TB
authors.lastname: Dorff
authors.affiliation: Institute of Urology, University of Southern California, Los Angeles, CA. Electronic address: anne.schuckman@med.usc.edu.
authors.forename: Anne K
authors.initials: AK
authors.lastname: Schuckman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010412:Penile Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Outcomes analysis; Pathology; Penile squamous cell carcinoma; Prognosis