Survival Analysis of Primary Tumor Staging (T), Lymph Node Status (N), Tumor Grading, Cell Subtype, Lymphovascular Invasion Status, and Preoperative Neutrophil-Lymphocyte Ratio Values in Penile Cancer

Abstract

Background: Penile cancer is rare but has a major impact on patients and health workers in its management. In penile cancer, tumors can grow anywhere in all parts of the penis, starting from the glans penis, foreskin, and shaft of the penis, which can spread and damage the surrounding tissue structures such as the pubic bone, scrotum, and others. No studies specifically analyze the survival of penile cancer. Aim: This study assessed the relationship between primary tumor staging, lymph node status, tumor grading, cell subtype, lymphovascular invasion (LVI), and preoperative neutrophil-lymphocyte ratio (NLR) on the survival of penile cancer patients. Material & Methods: This study was a survival analysis study with a retrospective cohort design. Primary tumor staging (T), lymph node status (N), tumor grading, cell subtype, LVI status, and preoperative NLR values are independent variables included. The dependent variables are survival time and mortality. Descriptive analysis, Kaplan-Meier curve analysis, and Cox Proportional Hazard Regression test were performed. Results: Eighty (80) subjects with a mean age of 55.71 ± 12.45 years old. Forty-one percent of the subjects died with a mean survival time of 60.65 months (95% CI 51.25-70.04). Cox proportional hazard regression analysis showed that staging N3 and the condylomatous subtype at the time of diagnosis increased the risk of mortality with a hazard ratio (HR) of 3.55 (95% CI 1.03 – 12.31) and 6.77 (95% CI). 1.02 – 44.85), respectively. Conclusion: Lymph node staging N3 and condylomatous subtype were factors with poorer survival prognosis.