Clinical Outcomes of Perioperative Chemotherapy in Patients With Locally Advanced Penile Squamous-Cell Carcinoma: Results of a Multicenter Analysis.
The prognosis of patients with locally advanced penile squamous-cell carcinoma is primarily related to the extent of lymph node metastases. Surgery alone yields suboptimal results, and there is a paucity of data on these patients' outcomes.



This retrospective study evaluated patients who received neoadjuvant or adjuvant chemotherapy from 1990 onward at 12 centers. Cox models were used to investigate prognostic factors for relapse-free survival and overall survival (OS).



Among the 201 included patients, 39 (19.4%) had disease of T3-4 and N0 clinical stage; the remaining patients had clinical lymph node involvement (cN+). Ninety-four patients received neoadjuvant chemotherapy (group 1), 78 received adjuvant chemotherapy (group 2), and 21 received both (group 3). Eight patients for whom the timing of perioperative chemotherapy administration was unavailable were included in the Cox analyses. Forty-three patients (21.4%) received chemoradiation. Multivariate analysis for OS (n = 172) revealed bilateral disease (P = .035) as a negative prognostic factor, while pelvic cN+ tended to be nonsignificantly associated with decreased OS (P = .076). One-year relapse-free survival was 35.6%, 60.6%, and 45.1% in the 3 groups, respectively. One-year OS was 61.3%, 82.2%, and 75%, respectively. No significant differences were seen on univariable analyses for OS between the groups (P = .45). Platinum type of chemotherapy and chemoradiation were not significantly associated with any outcome analyzed.



Benchmark survival estimates for patients receiving perioperative chemotherapy for locally advanced penile squamous-cell carcinoma have been provided, with no substantial differences observed between neoadjuvant and adjuvant administration. This analysis may result in improved patient information, although prospective studies are warranted.
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. Electronic address: andrea.necchi@istitutotumori.mi.it.
Andrea
A
Necchi
McMaster University, Hamilton, Ontario, Canada.
Gregory R
GR
Pond
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Daniele
D
Raggi
The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Sarah R
SR
Ottenhof
The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Rosa S
RS
Djajadiningrat
The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Simon
S
Horenblas
The Royal Marsden Hospital, London, United Kingdom.
Vincent
V
Khoo
University Hospital Rostock, Rostock, Germany.
Oliver W
OW
Hakenberg
University Hospital Rostock, Rostock, Germany.
Desiree
D
Draeger
University Hospital Rostock, Rostock, Germany.
Chris
C
Protzel
Universitätsklinikum Köln, Köln, Germany.
Axel
A
Heidenreich
Universitätsklinikum Köln, Köln, Germany.
Friederike
F
Haidl
British Columbia Cancer Agency, Vancouver, BC, Canada.
Bernie J
BJ
Eigl
British Columbia Cancer Agency, Vancouver, BC, Canada.
Lucia
L
Nappi
Kitasato University School of Medicine, Sagamihara, Japan.
Kazumasa
K
Matsumoto
Karmanos Cancer Institute, Detroit, MI.
Ulka
U
Vaishampayan
University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
Michael E
ME
Woods
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Roberto
R
Salvioni
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Nicola
N
Nicolai
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Mario
M
Catanzaro
Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Patrizia
P
Giannatempo
Fox Chase Cancer Center Temple Health, Philadelphia, PA.
Daniel M
DM
Geynisman
Università degli Studi di Torino, Ospedale Molinette, Torino, Italy.
Mirko
M
Preto
Cochin Hospital, APHP, Paris Descartes University, Paris, France.
Evanguelos
E
Xylinas
University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
Matthew I
MI
Milowsky
Università Federico II, Napoli, Italy.
Sabino
S
De Placido
Università Federico II, Napoli, Italy.
Giuseppe
G
Di Lorenzo
UAB Comprehensive Cancer Center, Birmingham, AL.
Guru
G
Sonpavde
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000601:surgery; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D010412:Penile Neoplasms / Q000188:drug therapy* / Q000601:surgery; D059035:Perioperative Period; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
Penile cancer; Preoperative chemotherapy; Regional lymph nodes; Squamous cell carcinoma; Survival