Mohamed H Kamel1, Jun Tao2, Joseph Su2, Mahmoud I Khalil3, Nabil K Bissada4, Benjamin Schurhamer5, Philippe E Spiess6, Rodney Davis5. 1. Department of Urology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: mkamel@uams.edu. 2. Department of Epidemiology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR. 3. Department of Urology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt. 4. Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Hospital, Houston, TX. 5. Department of Urology, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR. 6. Department of Genito-Urinary Oncology, Moffitt Cancer Center, Tampa, FL.
Abstract
PURPOSE: To describe the survival outcomes of organ sparing surgery (OSS), partial penectomy (PP), and total penectomy (TP) in pathological stage pT1/pT2 penile cancer (PC) as reported in the United States National Cancer Data Base. METHODS: Patients with pT1/pT2 PC, treated with surgery as their primary treatment modality were classified into 3 groups according to the type of surgery into OSS, PP, and TP. Patient and tumor characteristics of the groups were compared using bivariate analysis, and Cox- proportional hazard model was used for survival analysis. RESULTS: A total of 4,238 patients were examined. There were 1,211, 2,360, and 584 patients in the OSS, PP, and TP groups, respectively. In 83 patients, the type of surgery was missing. The 5- and 10-year overall survival rates for OSS, PP, and TP were 88% and 74% vs. 85% and 72% vs. 79% and 63%, respectively (P ≤ 0.001). In addition, in a multivariable model for predictors of patient survival, OSS did not predict poor patient survival (hazard ratio = 0.88, CI: 0.64-1.21). CONCLUSIONS: Our results demonstrate, at national level, OSS in early stage PC provided comparable outcomes in selected patients compared to PP and TP. Also, organ preservation was not associated with any significant reduction in patient survival in early stage PC. Our results help with early stage PC patient informed treatment decisions and anticipated outcomes.
PURPOSE: To describe the survival outcomes of organ sparing surgery (OSS), partial penectomy (PP), and total penectomy (TP) in pathological stage pT1/pT2 penile cancer (PC) as reported in the United States National Cancer Data Base. METHODS:Patients with pT1/pT2 PC, treated with surgery as their primary treatment modality were classified into 3 groups according to the type of surgery into OSS, PP, and TP. Patient and tumor characteristics of the groups were compared using bivariate analysis, and Cox- proportional hazard model was used for survival analysis. RESULTS: A total of 4,238 patients were examined. There were 1,211, 2,360, and 584 patients in the OSS, PP, and TP groups, respectively. In 83 patients, the type of surgery was missing. The 5- and 10-year overall survival rates for OSS, PP, and TP were 88% and 74% vs. 85% and 72% vs. 79% and 63%, respectively (P ≤ 0.001). In addition, in a multivariable model for predictors of patient survival, OSS did not predict poor patient survival (hazard ratio = 0.88, CI: 0.64-1.21). CONCLUSIONS: Our results demonstrate, at national level, OSS in early stage PC provided comparable outcomes in selected patients compared to PP and TP. Also, organ preservation was not associated with any significant reduction in patient survival in early stage PC. Our results help with early stage PC patient informed treatment decisions and anticipated outcomes.
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