Racial disparity and survival outcomes between African American and Caucasian men with penile cancer

To determine whether there was a survival difference for AAM versus CM with penile squamous cell carcinoma (pSCC), particularly in locally advanced and metastatic cases where disease mortality is highest.

Using the Florida Cancer Data System, we identified men with pSCC from 2005 to 2013. We compared age, follow-up, stage, race, and treatment type between AAM and CM. We performed Kaplan-Meier analysis for overall survival (OS) between AAM and CM for all stages, and for those with locally advanced and metastatic disease. A multivariable model was developed to determine significant predictors of OS.

653 men (94 AAM and 559 CM) had pSCC and 198 (30%) had locally advanced and/or metastatic disease. A higher proportion of AAM had locally advanced and/or metastatic disease compared to CM (N=38 (40%) vs 160 (29%), P=0.03). Median follow up for the entire cohort was 12.6 mos [IQR 5.4 - 32.0]. For all stages, AAM demonstrated significantly decreased median OS compared to CM (26 mos vs. 36 mos, P=0. 03). For locally advanced and metastatic disease, there was a consistent trend toward disparity in median OS between AAM and CM (17 mos vs. 22 mos, P=0.06). After adjusting for age, stage, grade, and treatment type, AAM with pSCC had an increased likelihood of death compared to CM (HR 1.64, P=.014).

AAM have worse overall survival compared to CM with pSCC and this may partly be due to advanced stage at presentation. Treatment disparity may also contribute to decreased survival in AAM, but, we were unable to demonstrated significant difference in treatment utilizations between groups. This article is protected by copyright. All rights reserved.

BJU international. 2017 Dec 27 [Epub ahead of print]

Chad R Ritch, Nachiketh Soodana Prakash, Nicola Pavan, Raymond R Balise, Maria Camila Velasquez, Mahmoud Alameddine, Desmond Y Adamu, Sanoj Punnen, Dipen J Parekh, Mark L Gonzalgo

Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL., Division of Biostatistics Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL.