Prognostic Factors for Penile Cancer and Survival in Response to Multimodality Therapy

Figures & data

Table 1 Demographics and Clinical Characteristics of 70 Penile Cancer Patients

	Stage I/II (n=28)	Stage III/IV (n=42)	Total (n=70)
Age at diagnosis (year)
Mean (SD)	53.9 (13.6)	54.5 (13.8)	54.2 (13.6)
Range	32–83	25–89	25–89
Presenting symptoms, n (%)
Penile mass	20 (80.0)	20 (57.2)	40 (66.7)
Penile ulcer	4 (16.0)	8 (22.9)	12 (20.0)
Groin mass	0	5 (14.3)	5 (8.3)
Penile pain/itching	1 (4.0)	1 (2.8)	2 (3.3)
Dysuria	0	1 (2.8)	1 (1.7)
Location, n (%)
Prepuce	0	2 (5.0)	2 (2.9)
Tip of penis	27 (96.4)	37 (92.5)	64 (94.2)
Shaft	1 (3.6)	1 (2.5)	2 (2.9)
Tumor grade, n (%)
Grade 1	25 (96.1)	27 (73.0)	52 (82.5)
Grade 2/3	1 (3.9)	10 (27.0)	11 (17.5)
ECOG performance status, n (%)
0–1	28 (100)	38 (90.5)	66 (82.9)
≥2	0	4 (9.5)	4 (5.7)
Time from presentation to diagnosis (months), median (range)	2.6 (0–40.3)	1.4 (0–53.7)	2.1 (0–53.7)

Abbreviation: ECOG, Eastern Cooperative Oncology Group.

Figure 1 Survival according to prognostic factors.

Notes: (A) Nodal involvement. (B) Metastasis. (C) ECOG performance status. (D) Histological grading.

Table 2 Univariate and Multivariate Analysis of Overall Survival According to Clinical and Pathological Characteristics

Variables	Median Survival (Months)	Univariate		Multivariate
		Unadjusted HR	95% CI	Adjusted HR	95% CI
Age (year)
<50	29.3
≥50	19.0	1.21	0.65–2.23
ECOG
0	47.2
≥1	10.5	2.99*	1.52–5.89	2.13	0.92–4.95
Nodal involvement
Positive	13.8	5.15*	2.49–10.64	5.74*	2.52–13.04
Negative	82
Metastasis
No	47.2
Yes	11.2	3.88*	1.74–8.64	1.54	0.64–3.67
Grade
Grade 1	45.4
Grade 2/3	10.5	2.15*	1.02–4.56	0.89	0.38–2.10

Note: *Statistically significant.

Table 3 Treatment Modality

Treatment	Surgery (n=29)	MMT (n=41)	Total (n=70)
Stage, n (%)
Stage I/II	20 (69.0)	8 (19.5)	28 (40.0)
Stage III/IV	9 (31.0)	33 (80.5)	42 (60.0)
Surgery, n (%)
No	0	4 (9.8)	4 (5.7)
Wide excision	5 (17.2)	6 (14.6)	11 (15.7)
Partial penectomy	21 (72.4)	17 (41.5)	38 (54.3)
Radical penectomy	3 (10.4)	14 (34.1)	17 (24.3)
Lymph node dissection, n (%)
No	19 (65.5)	20 (48.8)	39 (55.7)
Yes	10 (34.5)	21 (51.2)	31 (44.3)
Radiation, n (%)
No	29 (100)	10 (24.4)	39 (55.7)
Yes	0	31 (75.6)	31 (44.3)
Chemotherapy, n (%)
No	29 (100)	9 (21.9)	38 (54.3)
Cisplatin/Fluorouracil	0	24 (58.5)	24 (34.3)
Methotrexate/Fluorouracil	0	1 (2.4)	1 (1.4)
Carboplatin/Paclitaxel	0	1 (2.4)	1 (1.4)
TIP regimen	0	1 (2.4)	1 (1.4)
Platinum single agent	0	5 (12.2)	5 (7.2)

Figure 2 Kaplan-Meier estimates of OS for the stage IIIB/IV disease (n=39) by treatment modalities.