Penile cancer represents a rare pathology whose natural history of treatment is poorly understood.
To illustrate the dynamic survival profiles in surgically treated patients with squamous cell carcinoma of the penis (SCCP) using the conditional survival (CS) estimates.
Patients with non-metastatic SCCP were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Conditional 3-yr overall survival (OS) rate and 3-yr cancer-specific survival (CSS) rate represented the primary outcomes of interest and were calculated using the Kaplan-Meier method. The multivariable Cox regression model was employed to calculate proportional hazard ratios for the prediction of mortality.
A total of 1,887 SCCP patients who had undergone surgeries were identified. Given a 1-, 2-, 3-, 4-, and 5-yr survivorship, the 3-yr OS rates were respectively improved by +9.8 (72.6%), +18.2 (78.1%), +23.4 (81.6%), +27.8 (84.5%) and +26.6% (83.7%) from those calculated at baseline (time zero). As compared with the baseline calculations, patients who had survived 1, 2, 3, 4, or 5 yr after surgery could respectively harvest a +7.8 (84.7%), +14.8 (90.2%), +19.5 (93.9%), +22.1 (96.0%), and +22.4% (96.2%) improvement in 3-yr CSS. Patients with the most aggressive disease at baseline ultimately benefited the most from event-free survivorship. Multivariable Cox regression analyses showed that the impact of adverse pathological parameters (G2-3, ≥ pT2, pN+) on OS and CSS mostly showed a decreasing trend over time and some could disappear after a minimum of 1-yr survivorship.
The survival probability of SCCP patients increases with postoperative survival. Patients with aggressive disease at baseline ultimately benefit the most from event-free survivorship and may expect a better prognosis once they survive the critical few years after surgery. The recorded observations have crucial implications regarding patient counseling and follow-up.
Andrology. 2020 Jul 03 [Epub ahead of print]
Wei Liu, Yongwen Luo, Gang Wang, Nan Li, Zhiping Wang, Junhao Lei, Xinghuan Wang
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China., Cancer Precision Diagnosis and Treatment and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China., Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China., Department of Urology, Lanzhou University Second Hospital, Lanzhou, China.