Penile cancer (PC) is a rare malignancy with an overall incidence in Europe of 1/100,000 males/year. In Europe, few studies report the epidemiology, risk factors, clinical presentation, and treatment of PC. The aim of this study is to present an updated outlook on the aforementioned factors of PC in Spain.
A multicentric, retrospective, observational epidemiological study was designed, and patients with a new diagnosis of PC in 2015 were included. Patients were anonymously identified from the Register of Specialized Care Activity of the Ministry of Health of Spain. All Spanish hospitals recruiting patients in 2015 were invited to participate in the present study. We have followed a descriptive narration of the observed data. Continuous and categorical data were reported by median (p25th-p75th range) and absolute and relative frequencies, respectively. The incidence map shows differences between Spanish regions.
The incidence of PC in Spain in 2015 was 2.55/100,000 males per year. A total of 586 patients were identified, and 228 patients from 61 hospitals were included in the analysis. A total of 54/61 (88.5%) centers reported ≤ 5 new cases. The patients accessed the urologist for visually-assessed penile lesions (60.5%), mainly localized in the glans (63.6%). Local hygiene, smoking habits, sexual habits, HPV exposure, and history of penile lesions were reported in 48.2%, 59.6%, 25%, 13.2%, and 69.7%. HPV-positive lesions were 18.1% (28.6% HPV-16). The majority of PC was squamous carcinoma (95.2%). PC was ≥cT2 in 45.2% (103/228) cases. At final pathology, PC was ≥pT2 in 51% of patients and ≥pN1 in 17% of cases. The most common local treatment was partial penectomy (46.9% cases). A total of 47/55 (85.5%) inguinal lymphadenectomies were open. Patients with ≥pN1 disease were treated with chemotherapy in 12/39 (40.8%) of cases.
PC incidence is relatively high in Spain compared to other European countries. The risk factors for PC are usually misreported. The diagnosis and management of PC are suboptimal, encouraging the identification of referral centers for PC management.
Cancers. 2023 Jan 19*** epublish ***
Ángel Borque-Fernando, Josep Maria Gaya, Luis Mariano Esteban-Escaño, Juan Gómez-Rivas, Rodrigo García-Baquero, Fernando Agreda-Castañeda, Andrea Gallioli, Paolo Verri, Francisco Javier Ortiz-Vico, Balig Fawwaz Amir-Nicolau, Ignacio Osman-Garcia, Pedro Gil-Martínez, Miguel Arrabal-Martín, Álvaro Gómez-Ferrer Lozano, Felix Campos-Juanatey, Félix Guerrero-Ramos, Josè Rubio-Briones, Grupo Cooperativo de Registro Nacional Cáncer Pene (PIEM/AEU/2014/0002)
IIS-Aragón, Miguel Servet University Hospital, Universidad de Zaragoza, 50009 Zaragoza, Spain., Fundació Puigvert, Autonomus University of Barcelona, 08193 Barcelona, Spain., Applied Mathematics Department, Escuela Universitaria Politécnica de La Almunia, Universidad de Zaragoza, 50100 La Almunia de Doña Godina, Spain., Hospital Universitario La Paz, 28046 Madrid, Spain., Hospital Universitario Puerta del Mar, 11009 Cádiz, Spain., Hospital Germans Trias y Pujol, 08916 Badalona, Spain., Principe Asturias University Hospital, 28805 Alcala de Henares, Spain., Nuestra Señora de la Candelaria University Hospital, 38010 Santa Cruz de Tenerife, Spain., Virgen del Rocio University Hospital, 41013 Sevilla, Spain., Granada University Hospital, 18071 Granada, Spain., Instituto Valenciano de Urologia (IVO), 46009 Valencia, Spain., Marques de Valdecilla University Hospital, 39008 Santander, Spain., Hospital Universitario 12 de Octubre, 28041 Madrid, Spain., Clinica de Urología, Hospital VITHAS 9 de Octubre, 46015 Valencia, Spain.