Contemporary management of penile cancer: greater than 15 year MSKCC experience.
BACKGROUND
Penile cancer is a rare malignancy, and few guidelines are available to define treatment paradigms. For greater understanding of the natural history of surgically treated penile cancer, we analyzed the experience at our institution.


METHODS
Using an institutional database, we identified 127 patients treated for squamous cell carcinoma of the penis from 1995-2011. Cancer-specific survival (CSS) was calculated using the Kaplan-Meier method. Survival data were compared using the log-rank test. The difference in risk of cancer-specific death by lymph node status and histological grade was determined by univariate Cox regression analysis.


RESULTS
Five year CSS for pTis, pT1, pT2, and pT3/4 was 100%, 84% (95% CI 58%-95%), 54% (95% CI 33%-71%), and 54% (95% CI 25%-76%), respectively (p ≤ .005). Three year CSS for patients with N0, N+, and Nx disease was 90% (95% CI 47%-99%), 65% (95% CI 47%-79%), and 86% (95% CI 73%-93%), respectively (p = .03). The receipt of neoadjuvant chemotherapy did not change per 5 year period over the 16 years of our study. Median follow up was 2.8 years.


CONCLUSIONS
Penile cancer patients with advanced disease had poor survival. Tumor stage and nodal status were significant predictors of CSS. Penis-sparing approaches may be considered for most patients; however, pathological stage and grade dictate the management and ultimate outcome. Further studies are necessary to clarify the benefits of chemotherapy in this disease.
Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Kelvin A
KA
Moses
Andrew
A
Winer
John P
JP
Sfakianos
Stephen A
SA
Poon
Matthew
M
Kent
Melanie
M
Bernstein
Paul
P
Russo
Guido
G
Dalbagni
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy*; D019468:Disease Management; D018572:Disease-Free Survival; D004358:Drug Therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009519:New York City; D010412:Penile Neoplasms / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D013519:Urogenital Surgical Procedures