To report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC).
A retrospective analysis of men with penile sSCC diagnosed between Jan 2010 and Jan 2020 in a single centre was conducted. Disease-specific (DSS), recurrence-free (RFS) and metastasis-free (MFS) survival were evaluated. Outcomes were compared with a non-sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan-Meier (KM) plots were used to estimate survival outcomes.
1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (IQR) age and follow-up was 70 (57-81) years and 16 (7-44) months respectively. Operations performed included: circumcision, n=1 (2.6%); wide local excision, n=4 (10.5%); glansectomy, n=11 (29%); partial penectomy, n=10 (26%); subtotal/total penectomy, n=12 (32%). The KM estimated 12 months, 24 months and 36 months DSS was 62% (vs non-sarcomatoid, 67%), 43% (vs non-sarcomatoid, 67%) and 36% (vs non-sarcomatoid, 67%) respectively, p=0.03. The KM estimated 12 months and 24 months RFS was 47% (vs non-sarcomatoid, 60%) and; 28% (vs non-sarcomatoid, 55%) respectively, p=0.01. The MFS was 52% (vs non-sarcomatoid, 62%) at 12 months; and 37% (vs non-sarcomatoid, 57%) at 24 months p=0.04.
Sarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.
BJU international. 2023 May 11 [Epub ahead of print]
Karl H Pang, Benedict Girling, Elizabeth Osinibi, Paramvir Sawhney, Aiman Haider, Alex Freeman, Paul Hadway, Raj Nigam, Rowland Rees, Anita Mitra, Asif Muneer, Constantine Alifrangis, Hussain M Alnajjar
Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK., Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK., Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK., Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.