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Prognostic factors influencing survival from regionally advanced squamous cell carcinoma of the penis after preoperative chemotherapy
Author(s) -
Dickstein Rian J.,
Munsell Mark F.,
Pagliaro Lance C.,
Pettaway Curtis A.
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12946
Subject(s) - penis , basal cell , chemotherapy , medicine , carcinoma , oncology , urology , surgery
Objective To describe both clinical and pathological response rates, survival, and predictors of survival when using contemporary perioperative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma ( SCC ) of the penis. Patients and Methods Retrospective review of all patients diagnosed with SCC of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathological responses were reported. Recurrence‐free and overall survival was estimated using K aplan– M eier analysis. Cox proportional hazards regression was used to assess factors for survival. Results In all, 61 patients were identified, of which 54 (90%) received chemotherapy with paclitaxel/ifosfamide/cisplatin. In all, 39 patients (65%) had either a partial ( PR ) or complete response ( CR ) to chemotherapy. The 5‐year survival varied significantly ( P = 0.045–0.001) among patients achieving a CR / PR (50%), stable disease (25%), and progression (7.7%). In all, 10 patients (16.4%) were rendered pN0 with combined therapy and 20 patients (33%) were alive and disease free at a median follow‐up of 67 months, while 32 (52%) died from disease. Long‐term survival was associated with response to chemotherapy and favourable pathological findings after resection. Conclusion Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. About 50% of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.