Patients with advanced penile squamous cell cancer (pSCC) have a poor prognosis and can benefit from early palliative care consultation. We built a model to identify those patients most likely to benefit.
Patients with pSCC undergoing inguinal lymph node dissection (ILND) were identified from the National Cancer Database (NCDB) and a multi-institutional international dataset (INT). A multivariable Cox proportional hazards model for OS was developed using the NCDB and applied to the INT dataset. Parameters were used to make ROC curves. ROC-related criteria were optimized to identify a predictive probability cut point and dichotomize patients from INT into risk groups for limited OS of <6 and <12 months.
NCDB had 860 deaths; 105 (5%) at 6 months and 296 (15%) at 12 months. INT had 257 deaths; 56 (8%) at 6 months and 124 (18%) at 12 months. Limited OS was associated with older age, greater T and N stage, and fewer lymph nodes removed. Optimized ROC criteria using the OS <6 month curve best dichotomized INT patients into high risk group with median OS of 24 months (95% CI 18-34) and low risk group with median OS of 174 months (95% CI 120-NE.
We developed a simple model that could be used as a screening tool for early palliative care referral.
Urology. 2023 Jul 17 [Epub ahead of print]
Lee A Hugar, Taylor C Peak, Mahrukh Naqvi, Youngchul Kim, Marco Bandini, Filippo Pederzoli, Laura Marandino, Maarten Albersen, Eduard Roussel, Yao Zhu, Ding-Wei Ye, Antonio A Ornellas, Mario Catanzaro, Oliver W Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Alberto Briganti, Roberto Salvioni, Nicholas H Chakiryan, Francesco Montorsi, Andrea Necchi, Philippe E Spiess
Lexington Medical Center, Lexington Urology, Columbia, SC, USA., H Lee Moffitt Cancer Center, Department of Genitourinary Oncology, Tampa, FL, USA. Electronic address: ., H Lee Moffitt Cancer Center, Department of Biostatistics and Bioinformatics, Tampa, FL, USA., Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy., University Hospitals Leuven, Leuven, Belgium., Fudan University Shanghai Cancer Center, Shanghai, China., Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil., University Hospital Rostock, Rostock, Germany., Universitätsklinikum Köln, Köln, Germany., St. George's University Hospitals, NHS Foundation Trust, London, UK., H Lee Moffitt Cancer Center, Department of Genitourinary Oncology, Tampa, FL, USA.