San Diego, CA USA (UroToday.com) A very interesting podium presentation was presented in today’s sexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I session at the AUA 2016 that described Prognostic and pathologic factors determining outcomes in pT2/pT3 penile carcinomas: Time for a revised staging system.
Dr. Priya Rao reminded all that Tumors invading corpus spongiosum (CS) and/or corpora cavernosa (CC) are currently staged as pT2 tumors. The authors sought to assess the 7th edition TNM pathologic staging system for penile carcinoma and define the pathologic prognostic factors that determine clinical outcome. The study included 147 pts from 2 cancer institutes, who had radical penectomies between June 1999 & May 2013. The patients were divided into 4 groups:
Group1: CS involvement without LVI (N= 41)
Group2: CS involvement with LVI (n=42)
Group3: CC involvement (n=29)
Group4: Urethra involvement (n=35).
Overall and disease specific survival were estimated using the Kaplan-Meier method, and two-sided log-rank tests & Cox proportional hazards regression models adjusting for histologic grade. Median was 5.1 years. the authors found that overall survival was significantly associated with tumor grade (p<0.001) and pathologic group (p=0.003 ). Median disease specific survival was 1.5 years. On multivariate analysis DFS was significantly associated with pathologic group only. The authors showed that there is a significant statistical difference in OS and DFS when tumors currently classified as pT2/pT3 tumors are stratified into 4 groups. OS for tumors involving the CC is significantly worse than tumors involving the CS, behave similarly to tumors showing urethral involvement, thus warranting a separate T category. Furthermore, tumor grade did not significantly impact DFS in pT2 tumors, which was impacted by pathologic group alone.
Presented By: Priya Rao, MD
Written By: Miki Haifler MD. Fox Chase Cancer Center, Philadelphia, PA. at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA