SAN DIEGO, CA USA (UroToday.com) - These authors from the UK reviewed the clinical and survival outcomes of men with N+ disease penile cancer over the last 10 years.
Prospective data was collected for 100 N+ patients (Group A) between 2002-2012 and compared with N- patients (Group B) for the same period. Additionally, the outcomes for these men were compared against historical data (Group C; pre-2002).
Multivariate analysis identified independent clinical and histopathological predictors of advanced disease states and poor outcomes (time to recurrence and overall survival). Four hundred ten men were included in the study. Primary tumors for N+ patients were significantly associated with: higher grade and stage, presence of lymphovascular invasion, increased depth of invasion, and multifocality. Overall survival for N+ cohort was significantly worse than N- cohort (HR 8.50 (2.74 to 26.34). Presence of extranodal spread (p=0.002) was also a significant predictor of death. Thirty-seven men received adjuvant/palliative chemotherapy and/or radiotherapy. One- and 3-year survival rates following adjuvant XRT were 90% and 67%, respectively, and palliative XRT had 1- and 3-year survival rates of 40% and 38%, respectively.
Authors showed that presence and extent of nodal involvement continue to be the most important prognostic factors in patients with penile cancer and that adjuvant therapy can potentially improve outcomes in these men. However, prospective randomized studies are needed.
Presented by Oliver Kayes, David Lau, Raj Nigam, Asif Muneer, David Ralph, Peter Malone, and Suks Minhas at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Reza Mehrazin, MD