MP10-06 SURGICAL TREATMENT OF PRIMARY DISEASE FOR PENILE SQUAMOUS CELL CARCINOMA: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS (SEER) DATABASE ANALYSIS

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Penis/Testis/Urethra: Malignant Disease1 Apr 2015MP10-06 SURGICAL TREATMENT OF PRIMARY DISEASE FOR PENILE SQUAMOUS CELL CARCINOMA: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS (SEER) DATABASE ANALYSIS Gu Weijie, Zhu Yao, and Ye Dingwei Gu WeijieGu Weijie More articles by this author , Zhu YaoZhu Yao More articles by this author , and Ye DingweiYe Dingwei More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.407AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Current guidelines recommend penile sparing surgery (PSS) for select penile cancer. This study describes the use of PSS in a population-based cohort, and also examines the role of PSS on penile cancer specific mortality (PCSM). METHODS Surveillance, Epidemiology, and End Results (SEER) data were used to identify individuals who were diagnosed with penile squamous cell carcinoma from 1998 to 2009 and treated with surgery. Patients were sorted into 2 groups: local tumor excision (LTE), and partial/total penectomy (PE). We examined factors associated with the receipt of LTE and PCSM after LTE. Comparison of PCSM was made between LTE and PE after propensity score matching. RESULTS Of 1292 eligible subjects, 24.2% underwent LTE. For stage T1 disease, the rates of LTE increased moderately from 29% to 40% over last decade. After adjustment, young age, black race, tumor size of <3cm, and stage T1 disease positively influenced the receipt of LTE. With a median follow-up of 55 months, the 4-year PCSM was 9.8% in patients treated with LTE. Older age, tumor size of 3 to 4cm and spread disease in SEER stage were significant predictors of PCSM. In matched cohort with stage T1 disease, the 4-year PCSM were 8.9% and 10.0% for patients received LTE or PE, respectively (p=0.93). CONCLUSIONS Underuse of PSS is pronounced in the general community with significant age and race disparities. The population-based study provides evidence supporting the oncological safety of PSS as compared with PE in early stage disease. Multivariate analyses of predictors for the receipt of local tumor excision in patients with penile squamous cell carcinoma (n=1292) Variables Odds ratio (95% CI) p value Age 0.99 (0.98-1.00) <0.01 Race (ref= White) Black 1.72 (1.07-2.75) 0.02 Other 0.9 (0.46-1.75) 0.75 Marrital status (ref= Married) Unmarried 1.30 (0.97-1.75) 0.08 Primary tumor size (ref=< 1) 1-1.9 1.20 (0.74-1.96) 0.46 2-2.9 0.70 (0.43-1.14) 0.15 3-3.9 0.44 (0.25-0.75) <0.01 >4 0.37 (0.21-0.63) <0.01 T-stage (ref=T1) T2 0.18 (0.10-0.31) <0.01 T3-T4 0.16 (0.08-0.31) <0.01 SEER stage (ref=Localized) Regional 1.09 (0.68-1.74) 0.71 Distant 1.16 (0.40-3.37) 0.78 Grade (ref=Grade I) Grade II 0.92 (0.67-1.26) 0.60 Grade III-IV 0.77 (0.50-1.17) 0.21 Year of diagnosis (ref=1988-2000) 2001-2003 1.31 (0.81-2.14) 0.28 2004-2006 1.46 (0.90-2.37) 0.12 2007-2009 1.38 (0.86-2.21) 0.18 CI, confidence interval; SEER, Surveillance Epidemiology and End Results Program. Propensity score matching of surgical procedures in patients with stage T1 disease Variables Local tumor excision Before matching Penectomy p-value After matching Penectomy p-value n 265 434 265 Age <0.01 0.84 Mean 64.7 67.7 65.0 Race 0.48 0.21 White 222 375 229 Black 30 37 19 Other 13 22 17 Marrital status 0.53 0.23 Married 167 285 181 Unmarried 98 149 84 Grade 0.42 0.33 Grade I 100 143 85 Grade II 122 219 138 Grade III-IV 43 72 42 Primary tumor size <0.01 0.92 <1 38 48 44 1-1.9 97 94 88 2-2.9 67 109 68 3-3.9 33 91 33 >4 30 92 32 SEER Stage 0.29 0.66 Localized 242 384 238 Regional/Distant 23 50 27 Propensity Score <0.01 0.55 Mean 0.59 0.64 0.59 SEER, Surveillance Epidemiology and End Results Program. Multivariate analyses of predictors of penile cancer specific mortality in patients treated with local tumor excision (n=313) Variables Odds ratio (95% CI) p value Age 1.03 (1.00-1.05) 0.03 Race (ref=White) Black/Other 0.15 (0.02-1.21) 0.08 Marrital status (ref=Married) Unmarried 0.75 (0.31-1.80) 0.52 Primary tumor size (ref=< 1) 1-1.9 1.00 (0.19-5.17) 1.00 2-2.9 2.41 (0.50-11.52) 0.27 3-3.9 6.79 (1.32-35.07) 0.02 >4 1.99 (0.35-11.32) 0.44 T-stage (ref=T1) T2-T4 0.49 (0.15-1.55) 0.22 SEER stage (ref=Localized) Regional/Distant 4.83 (1.74-13.38) <0.01 Grade (ref=Grade I) Grade II 0.76 (0.29-2.00) 0.58 Grade III-IV 0.94 (0.27-3.23) 0.92 CI, confidence interval; SEER, Surveillance Epidemiology and End Results Program. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e112-e113 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gu Weijie More articles by this author Zhu Yao More articles by this author Ye Dingwei More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...