Danish National Penile Cancer Database, DaPeCa-Data: Characteristics, Management, and Survival 2000-2025 - Beyond the Abstract
In this study, we present the DaPeCa-data platform, along with an initial study of 1,397 Danish patients diagnosed with penile cancer between 2000 and 2025. The cohort reflects centralized management, with the majority of patients undergoing surgical nodal staging and curative-intent treatment. Notably, 87% of patients underwent lymph node staging as part of primary management, underscoring the strong adherence to guideline-recommended practice and centralized, highly specialized care in Denmark. Furthermore, 63% underwent whole-body FDG-PET/CT as part of the pre-treatment evaluation.
Several findings merit emphasis. First, survival outcomes were favorable in patients treated with curative intent, with a 5-year penile cancer–specific mortality of 11%. Second, as consistently demonstrated in penile cancer, both primary tumor stage and nodal status were the strongest predictors of outcome, reinforcing the importance of accurate staging and early detection. Perineural invasion of the primary tumor was also identified as an independent predictor of disease-specific survival, underscoring the importance of thorough histopathological assessment of the resected specimen.
We also observed temporal shifts in both disease characteristics and management. A higher proportion of patients in recent years presented with more advanced disease and were managed with non-curative intent. This likely reflects evolving referral patterns and increasing centralization, whereby more complex cases are now evaluated at specialized centers.
From a clinical perspective, these findings highlight the importance of structured national systems for rare cancers. The high rate of surgical staging and centralized care in Denmark may contribute to the observed outcomes and provide a potential model for other healthcare systems. However, the retrospective design, 25-year study period, and potential underrepresentation of patients managed outside tertiary centers should be considered when interpreting survival estimates.
Importantly, this study not only describes a cohort but also introduces a sustainable national clinical database platform. With more than 150 variables per patient and ongoing prospective maintenance, DaPeCa-data offers a strong foundation for future research, including risk stratification, treatment optimization, and quality improvement initiatives. The feasibility in main-taining this database rests on a centralized multidisciplinary system with enthusiastic penile cancer specialists from urology, oncology, and pathology working together in the pursuit of optimising management, care, and survival of penile cancer patients.
In summary, this work provides contemporary, population-based insight into the presentation, management, and outcomes of penile cancer in Denmark. It reinforces the central role of nodal staging, reflects evolving treatment patterns, and establishes an infrastructure that will be critical for advancing research in this rare disease.
Written by: Janni Mølsted, MD, PhD Student, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
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