Prognostic factors influencing survival from regionally advanced squamous cell carcinoma of the penis after preoperative chemotherapy

Rian J. Dickstein, Mark F. Munsell, Lance C. Pagliaro, Curtis A. Pettaway

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective To describe both clinical and pathological response rates, survival, and predictors of survival when using contemporary perioperative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma (SCC) of the penis. Patients and Methods Retrospective review of all patients diagnosed with SCC of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathological responses were reported. Recurrence-free and overall survival was estimated using Kaplan-Meier analysis. Cox proportional hazards regression was used to assess factors for survival. Results In all, 61 patients were identified, of which 54 (90%) received chemotherapy with paclitaxel/ifosfamide/cisplatin. In all, 39 patients (65%) had either a partial (PR) or complete response (CR) to chemotherapy. The 5-year survival varied significantly (P = 0.045-0.001) among patients achieving a CR/PR (50%), stable disease (25%), and progression (7.7%). In all, 10 patients (16.4%) were rendered pN0 with combined therapy and 20 patients (33%) were alive and disease free at a median follow-up of 67 months, while 32 (52%) died from disease. Long-term survival was associated with response to chemotherapy and favourable pathological findings after resection. Conclusion Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. About 50% of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.

Original languageEnglish (US)
Pages (from-to)118-125
Number of pages8
JournalBJU International
Volume117
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

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Penis
Squamous Cell Carcinoma
Drug Therapy
Survival
Lymph Node Excision
Penile Neoplasms
Ifosfamide
Kaplan-Meier Estimate
Disease Progression
Survival Rate
Lymph Nodes
Neoplasm Metastasis
Recurrence

Keywords

  • antineoplastic agents
  • lymph node excision
  • penile neoplasms
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Prognostic factors influencing survival from regionally advanced squamous cell carcinoma of the penis after preoperative chemotherapy. / Dickstein, Rian J.; Munsell, Mark F.; Pagliaro, Lance C.; Pettaway, Curtis A.

In: BJU International, Vol. 117, No. 1, 01.01.2016, p. 118-125.

Research output: Contribution to journalArticle

Dickstein, Rian J. ; Munsell, Mark F. ; Pagliaro, Lance C. ; Pettaway, Curtis A. / Prognostic factors influencing survival from regionally advanced squamous cell carcinoma of the penis after preoperative chemotherapy. In: BJU International. 2016 ; Vol. 117, No. 1. pp. 118-125.
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abstract = "Objective To describe both clinical and pathological response rates, survival, and predictors of survival when using contemporary perioperative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma (SCC) of the penis. Patients and Methods Retrospective review of all patients diagnosed with SCC of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathological responses were reported. Recurrence-free and overall survival was estimated using Kaplan-Meier analysis. Cox proportional hazards regression was used to assess factors for survival. Results In all, 61 patients were identified, of which 54 (90{\%}) received chemotherapy with paclitaxel/ifosfamide/cisplatin. In all, 39 patients (65{\%}) had either a partial (PR) or complete response (CR) to chemotherapy. The 5-year survival varied significantly (P = 0.045-0.001) among patients achieving a CR/PR (50{\%}), stable disease (25{\%}), and progression (7.7{\%}). In all, 10 patients (16.4{\%}) were rendered pN0 with combined therapy and 20 patients (33{\%}) were alive and disease free at a median follow-up of 67 months, while 32 (52{\%}) died from disease. Long-term survival was associated with response to chemotherapy and favourable pathological findings after resection. Conclusion Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. About 50{\%} of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.",
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N2 - Objective To describe both clinical and pathological response rates, survival, and predictors of survival when using contemporary perioperative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma (SCC) of the penis. Patients and Methods Retrospective review of all patients diagnosed with SCC of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathological responses were reported. Recurrence-free and overall survival was estimated using Kaplan-Meier analysis. Cox proportional hazards regression was used to assess factors for survival. Results In all, 61 patients were identified, of which 54 (90%) received chemotherapy with paclitaxel/ifosfamide/cisplatin. In all, 39 patients (65%) had either a partial (PR) or complete response (CR) to chemotherapy. The 5-year survival varied significantly (P = 0.045-0.001) among patients achieving a CR/PR (50%), stable disease (25%), and progression (7.7%). In all, 10 patients (16.4%) were rendered pN0 with combined therapy and 20 patients (33%) were alive and disease free at a median follow-up of 67 months, while 32 (52%) died from disease. Long-term survival was associated with response to chemotherapy and favourable pathological findings after resection. Conclusion Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. About 50% of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.

AB - Objective To describe both clinical and pathological response rates, survival, and predictors of survival when using contemporary perioperative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma (SCC) of the penis. Patients and Methods Retrospective review of all patients diagnosed with SCC of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathological responses were reported. Recurrence-free and overall survival was estimated using Kaplan-Meier analysis. Cox proportional hazards regression was used to assess factors for survival. Results In all, 61 patients were identified, of which 54 (90%) received chemotherapy with paclitaxel/ifosfamide/cisplatin. In all, 39 patients (65%) had either a partial (PR) or complete response (CR) to chemotherapy. The 5-year survival varied significantly (P = 0.045-0.001) among patients achieving a CR/PR (50%), stable disease (25%), and progression (7.7%). In all, 10 patients (16.4%) were rendered pN0 with combined therapy and 20 patients (33%) were alive and disease free at a median follow-up of 67 months, while 32 (52%) died from disease. Long-term survival was associated with response to chemotherapy and favourable pathological findings after resection. Conclusion Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. About 50% of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.

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