MP11-06 PREDICTIVE FACTORS FOR LOCAL RECURRENCE (LR) AND CANCER-SPECIFIC SURVIVAL (CSS. AN EUROGEN RISK STRATIFICATION FOR GRADE 2 AND GRADE 3 TUMOURS

Abstract

INTRODUCTION AND OBJECTIVE: The 8th edition of the unified TNM staging for penile SCC considers G2 disease as intermediate risk. The aim of this study was to analyse and compare predictors for LR and CSS between G2 and G3 tumours. METHODS: A retrospective analysis of 494 patients treated for penile SCC between 2008 and 2019 was performed. Univariate and multivariate Cox proportional hazards regression models were used to identify predictors for LR and CSS in grade 2 and grade 3 penile SCC. Kaplan-Meier analysis displayed CSS and recurrence free survival. RESULTS: 494 patients with penile SCC were identified from an institutional database. The median follow-up for LR and CSS was 58 months (IQR 25-93) and 35 months (IQR 25-93) respectively. At Cox regression univariate analysis, the only predictor for LR was lymphovascular invasion (LVI) (p=0.003). At univariate Cox regression analysis predictors for CSS included LVI, peri-neural invasion (PNI), inguinal lymph node disease, extracapsular spread (ECS), distant metastatic disease, pathological T-stage (all p<0.0001) and G2 vs. G3 (p=0.003). On multivariate analysis for CSS, only ECS, LVI, pathological T-stage and metastasis were found as independent predictors for CSS (all p<0.005). At multivariate analysis for CSS, G2 vs. G3 showed a p-value of 0.48 indicating that tumour grade does not contribute significantly compared to other independent predictors for CSS and LR. CONCLUSIONS: The EAU guidelines classify T1G2 tumours as intermediate risk when deciding options for inguinal lymph node management. Our findings suggest that the outcomes for G2 penile SCC are similar to G3 tumours and therefore dynamic sentinel lymph node biopsy should therefore be offered to patients presenting with grade 2 penile SCC with clinically impalpable inguinal nodes.Source of Funding: /