Advertisement

Conditional survival of patients with stage I–III squamous cell carcinoma of the penis: temporal changes in cancer-specific mortality

  • Francesco Alessandro MistrettaEmail author
  • Carlotta Palumbo
  • Sophie Knipper
  • Elio Mazzone
  • Angela Pecoraro
  • Zhe Tian
  • Gennaro Musi
  • Paul Perrotte
  • Emanuele Montanari
  • Shahrokh F. Shariat
  • Fred Saad
  • Alberto Briganti
  • Ottavio de Cobelli
  • Pierre I. Karakiewicz
Original Article
  • 9 Downloads

Abstract

Purpose

To test the conditional survival that examined the effect of event-free survival on cancer-specific mortality after primary tumour excision (PTE) in patients with squamous cell carcinoma of the penis (SCCP).

Materials and methods

Within the SEER database (1998–2015), 2282 stage I–III SCCP patients were identified. Conditional survival estimates were used to calculate cancer-specific mortality (CSM) after event-free survival intervals of 1, 2, 3, and 5 years. Multivariable Cox regression models predicted CSM according to event-free survival.

Results

After PTE, 5-year CSM-free rate was 78.0% and increased to 84.6%, 88.1%, 92.0%, and 94.2% in patients who survived ≥ 1, ≥ 2, ≥ 3, and ≥ 5 years. After stratification according to tumour characteristics, 5-year CSM-free rates increased from 85.9 to 95.4%, 79.0 to 97.1%, 78.9 to 90.0%, and from 54.5 to 86.0% in those survived ≥ 5 years, respectively, in T1N0, T2N0, T3N0, and N1-2 patients. In multivariable analyses, T2N0 [hazard ratio (HR) 1.68; p value < 0.001], T3N0 (HR 1.94; p value 0.001), and N1-2 (HR 6.61; p value < 0.001) were independent predictors of higher CSM rate at baseline, relative to T1N0. A decrease in all HRs was assessed over time in patients who survived. Attrition due to CSM was highest in N1-2 cohort and lowest in T1N0.

Conclusions

Conditional survival models showed a direct relationship between event-free survival duration and subsequent CSM in SCCP patients. Even patients with non-organ-confined disease may achieve survival probabilities similar to those with organ-confined disease after at least 5 years of event-free survival since PTE.

Keywords

Penile neoplasms Squamous cell carcinoma Mortality SEER program 

Abbreviations

CS

Conditional survival

CSM

Cancer-specific mortality

ICD-O

International classification of disease for oncology

ILND

Inguinal lymph-node dissection

HR

Hazard ratio

OCM

Other-cause mortality

PTE

Primary tumour excision

SCCP

Squamous cell carcinoma of the penis

SEER

Surveillance, epidemiology, and end results

Notes

Author contribution

FAM: project development, data collection, data analysis and interpretation, and manuscript writing. CP: manuscript writing. SK: data collection. EM: data analysis and interpretation. AP: data collection. ZT: data analysis. GM: manuscript editing. PP: manuscript editing. EM: manuscript review. SFS: manuscript review. FS: manuscript review. AB: manuscript editing. OC: manuscript review. PIK: project development and manuscript editing.

Compliance with ethical standards

Conflict of interest

Authors declare no conflicts of interest, including specific financial interests or relationships or affiliations relevant to the subject matter or materials discussed in the manuscript.

Ethical approval

The retrospective and anonymously coded study design was approved by the Institutional Review Board of the Centre Hospitalier de l’Université de Montreal.

Supplementary material

345_2019_2869_MOESM1_ESM.docx (91 kb)
Supplementary material 1 (DOCX 90 kb)

References

  1. 1.
    Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68(1):7–30CrossRefGoogle Scholar
  2. 2.
    Horenblas S (2001) Lymphadenectomy for squamous cell carcinoma of the penis. Part 2: the role and technique of lymph node dissection. BJU Int 88(5):473–483CrossRefGoogle Scholar
  3. 3.
    Stephenson AJ et al (2005) Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. J Clin Oncol 23(28):7005–7012CrossRefGoogle Scholar
  4. 4.
    Sun M et al (2012) Conditional survival of patients with urothelial carcinoma of the urinary bladder treated with radical cystectomy. Eur J Cancer 48(10):1503–1511CrossRefGoogle Scholar
  5. 5.
    Bianchi M et al (2013) Conditional survival after nephrectomy for renal cell carcinoma (RCC): changes in future survival probability over time. BJU Int 111(8):E283–E289CrossRefGoogle Scholar
  6. 6.
    Ploussard G et al (2015) Conditional survival after radical nephroureterectomy for upper tract carcinoma. Eur Urol 67(4):803–812CrossRefGoogle Scholar
  7. 7.
    Henson DE, Ries LA, Carriaga MT (1995) Conditional survival of 56,268 patients with breast cancer. Cancer 76(2):237–242CrossRefGoogle Scholar
  8. 8.
    Skuladottir H, Olsen JH (2003) Conditional survival of patients with the four major histologic subgroups of lung cancer in Denmark. J Clin Oncol 21(16):3035–3040CrossRefGoogle Scholar
  9. 9.
    Fuller CD et al (2007) Conditional survival in head and neck squamous cell carcinoma: results from the SEER dataset 1973–1998. Cancer 109(7):1331–1343CrossRefGoogle Scholar
  10. 10.
    Choi M et al (2008) Conditional survival in ovarian cancer: results from the SEER dataset 1988–2001. Gynecol Oncol 109(2):203–209CrossRefGoogle Scholar
  11. 11.
    Chang GJ et al (2009) Practical application of a calculator for conditional survival in colon cancer. J Clin Oncol 27(35):5938–5943CrossRefGoogle Scholar
  12. 12.
    Thuret R et al (2011) Conditional survival predictions after surgery for patients with penile carcinoma. Cancer 117(16):3723–3730CrossRefGoogle Scholar
  13. 13.
    SEER Cancer Statistics Review (2017) Available from: https://seer.cancer.gov/data-software/documentation/seerstat/nov2016/. Accessed 1 Oct 2018
  14. 14.
    Amin MB et al (2017) AJCC cancer staging manual. Springer, ChamCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Francesco Alessandro Mistretta
    • 1
    • 2
    Email author
  • Carlotta Palumbo
    • 1
    • 3
  • Sophie Knipper
    • 1
    • 4
  • Elio Mazzone
    • 1
    • 5
  • Angela Pecoraro
    • 1
    • 6
  • Zhe Tian
    • 1
  • Gennaro Musi
    • 2
  • Paul Perrotte
    • 1
    • 7
  • Emanuele Montanari
    • 8
  • Shahrokh F. Shariat
    • 9
  • Fred Saad
    • 1
    • 7
  • Alberto Briganti
    • 3
  • Ottavio de Cobelli
    • 2
    • 10
  • Pierre I. Karakiewicz
    • 1
    • 7
  1. 1.Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health CenterMontrealCanada
  2. 2.Department of UrologyEuropean Institute of OncologyMilanItaly
  3. 3.Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public HealthUniversity of BresciaBresciaItaly
  4. 4.Martini-Klinik, Prostate Cancer CentreUniversity Hospital Hamburg-EppendorfHamburgGermany
  5. 5.Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San RaffaeleVita-Salute San Raffaele UniversityMilanItaly
  6. 6.Department of UrologySan Luigi Gonzaga Hospital, University of TurinOrbassano, TurinItaly
  7. 7.Division of UrologyUniversity of Montreal Hospital Center (CHUM)MontrealCanada
  8. 8.Department of Urology, IRCCS Fondazione Ca’ Granda-Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
  9. 9.Department of UrologyMedical University of ViennaViennaAustria
  10. 10.Dipartimento di Emato-Oncologia ed OncologiaUniversity of MilanMilanItaly

Personalised recommendations