J Korean Med Sci.  2018 Sep;33(37):e233. 10.3346/jkms.2018.33.e233.

Prognostic Factors of Penile Cancer and the Efficacy of Adjuvant Treatment after Penectomy: Results from a Multi-institution Study

• Kim JW
• Kim YS
• Ko WJ
• Choi YD
• Hong SJ
• Chung BH
• Lee KS

• KMID: 2420200
• DOI: http://doi.org/10.3346/jkms.2018.33.e233

Abstract

BACKGROUND
Penile cancer is a rare malignancy associated with high rates of mortality and morbidity. Currently, the efficacy of adjuvant treatment (AT), including radiotherapy and chemotherapy, for penile cancer remains unclear. Therefore, we investigated the prognostic factors for treatment outcomes and the efficacy of AT in consecutive patients who underwent penectomy for penile cancer at multiple Korean institutions between 1999 and 2013.
METHODS
AT was defined as the administration of chemotherapy, radiotherapy, or both within 12 months after initial treatment. All patients were divided into two groups according to the AT status.
RESULTS
Forty-three patients (median age 67.0 years) with a median follow-up after penectomy of 26.4 (interquartile range: 12.0-62.8) months were enrolled. Patients with AT had a significantly higher pathologic stage. However, no differences in age, histologic grade, or type of surgery were identified according to the presence of AT. The 3- and 5-year cancer-specific survival (CSS) rates were 79.0% and 33.0%, respectively. In a multivariate analysis, American Joint Committee on Cancer (AJCC) stage ≥ III disease was an independent predictor of CSS and recurrence-free survival (RFS). However, AT was not associated with CSS and RFS. The type of primary surgical treatment and inguinal lymph node dissection at diagnosis were also not significantly associated with overall survival, CSS, or RFS.
CONCLUSION
AJCC stage ≥ III disease, which mainly reflects lymph node positivity, is a significant prognosticator in patients with penile cancer. By contrast, AT does not seem to affect CSS and RFS.

Keyword

Adjuvant Chemotherapy; Adjuvant Radiotherapy; Penile Cancer; Prognosis

MeSH Terms

Chemotherapy, Adjuvant
Diagnosis
Drug Therapy
Follow-Up Studies
Humans
Joints
Lymph Node Excision
Lymph Nodes
Male
Mortality
Multivariate Analysis
Penile Neoplasms*
Prognosis
Radiotherapy
Radiotherapy, Adjuvant