Trends of multimodal therapy in high-stage penile cancer.

Abstract

370 Background: Penile cancer (PC) is associated with high mortality and treatment failure in higher stage disease. While no prospective data exists, small anecdotal reports advocate the use of perioperative chemotherapy and/or radiotherapy for advanced disease. The 2013 National Comprehensive Cancer Network (NCCN) guidelines advocate the use of multimodal therapy for advanced disease. This study aimed to examine the trend in the use of perioperative chemotherapy or radiotherapy for advanced stage PC in the U.S. from 2000 – 2011. Methods: The National Cancer Database (NCDB) Datalinks Portal was queried. Diagnosis by year, first course treatment by stage, in all hospitals from 2000 – 2011 was obtained. Percentages of men treated with surgery alone, surgery with radiation, and surgery with chemotherapy in stages III and IV by year were determined to assess trends. Results: From 2000 – 2011, there were 1,028 and 440 men diagnosed with stage III and IV PC, respectively, who were recorded as having either surgery alone, surgery with radiation (+XRT), or surgery with chemotherapy (+Chemo). Addition of radiation therapy was variable, but low. Addition of chemotherapy has gradually increased, most dramatically in stage III PC. Conclusions: Consistent with the 2013 NCCN guidelines on penile cancer, the use of multimodal therapy for higher stage PC has increased, though modestly. Surgery with chemotherapy is the most common multimodal therapy. Further studies are needed to determine if this corresponds to a change in PC mortality. [Table: see text]