A Risk Calculator Predicting Recurrence in Lymph Node Metastatic Penile Cancer.

To date, no validated prognostic tool is available in patients with penile squamous cell carcinoma (pSCC) and inguinal lymph node metastases (ILNM). We aimed to develop and externally validate a risk calculator for prediction of any cancer recurrence in ILNM pSCC patients.

The development cohort included 234pts from 7 referral centers. The external validation cohort included 273pts from 2 additional referral centers. Cox regression identified predictors of any recurrence, which were used to develop a risk calculator. The risk-calculator grouped the development and the validation cohorts according to the individual risk of any recurrence at 24 months (24m-R). Adjuvant treatment effects were tested on overall survival (OS) according to the derived tertiles, within the development and validation cohorts.

Positive surgical margins, pN3 , and ILNM ratio were associated with higher recurrence rate. Two-year OS rates were lower for patients with high (>37%) and intermediate (19-37%) compared to low (<19%) 24m-R risk of recurrence, for both the development (43% and 58% vs. 83%, p<0.001) and validation cohort (44% and 50% vs. 85%, p<0.001). Results were confirmed in the subgroup of patients who did not receive adjuvant treatment (p<0.001), but not in patients who did receive adjuvant treatments in both the development and validation cohorts (p>0.1).

Adjuvant treatment planning is crucial in patients with lymph node metastatic penile cancer, where only weak evidences are available. The current tool proved to successfully stratify patients according to their individual risk, potentially allowing better tailoring of adjuvant treatments.

BJU international. 2020 Jul 14 [Epub ahead of print]

Marco Bandini, Philippe E Spiess, Filippo Pederzoli, Laura Marandino, Oscar R Brouwer, Maarten Albersen, Eduard Roussel, Hielke M de Vries, Juan Chipollini, Yao Zhu, Ding-Wei Ye, Antonio A Ornellas, Mario Catanzaro, Oliver W Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Mohamed E Ahmed, Jeffrey R Karnes, Alberto Briganti, Roberto Salvioni, Francesco Montorsi, Mounsif Azizi, Andrea Necchi

Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Moffitt Cancer Center and Research Institute, Tampa, FL, United States., Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy., The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., 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, United Kingdom., Department of Urology, Mayo Clinic, Rochester, Minnesota, United States.