Few studies have examined the role of radiation therapy in advanced penile squamous cell carcinoma. We sought to evaluate the association of adjuvant pelvic radiation with survival and recurrence for patients with penile cancer and positive pelvic lymph nodes (PLNs) after lymph node dissection.
Data were collected retrospectively across 4 international centers of patients with penile squamous cell carcinoma undergoing lymph node dissections from 1980 to 2013. Further, 92 patients with available adjuvant pelvic radiation status and positive PLNs were analyzed. Disease-specific survival (DSS) and recurrence were analyzed using the Kaplan-Meier method and multivariable Cox proportional hazards model.
43% (n = 40) of patients received adjuvant pelvic radiation after a positive PLN dissection. Median follow-up was 9.3 months (interquartile range: 5.2-19.8). Patients receiving adjuvant pelvic radiation had a median DSS of 14.4 months vs. 8 months in the nonradiation group, respectively (P = 0.023). Patients without adjuvant pelvic radiation were associated with worse overall survival (hazard ratio [HR] = 1.7; 95% CI: 1.01-2.92; P = 0.04) and DSS (HR = 1.9; 95% CI: 1.09-3.36; P = 0.02) on multivariable analysis. Median time to recurrence was 7.7 months vs. 5.3 months in the radiation and nonradiation arm, respectively (P = 0.042). Patients without adjuvant pelvic radiation was also independently associated with higher overall recurrence on multivariable analysis (HR = 1.8; 95% CI: 1.06-3.12; P = 0.03).
Adjuvant pelvic radiation is associated with improved survival and decreased recurrence in this population of patients with penile cancer with positive PLNs.
Urologic oncology. 2017 Jun 27 [Epub ahead of print]
Dominic H Tang, Rosa Djajadiningrat, Gregory Diorio, Juan Chipollini, Zhenjun Ma, Braydon J Schaible, Mario Catanzaro, Dingwei Ye, Yao Zhu, Nicola Nicolai, Simon Horenblas, Peter A S Johnstone, Philippe E Spiess
Department of Urology, Moffitt Cancer Center, Tampa, FL. Electronic address: ., Department of Urology, Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, Netherlands., Department of Urology, Moffitt Cancer Center, Tampa, FL., Department of Bioinformatics and Biostatistics, Moffitt Cancer Center, Tampa, FL., Department of Urology, Fondazione IRCCS IstitutoNazionaleTumori, Milano, Italy., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China., Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.