Temporal trends, tumor characteristics and stage-specific survival in penile non-squamous cell carcinoma vs. squamous cell carcinoma

Abstract

Purpose To compare Cancer-specific mortality (CSM) in patients with Squamous cell carcinoma (SCC) vs. non-SCC penile cancer, since survival outcomes may differ between histological subtypes. Methods Within the Surveillance, Epidemiology and End Results database (2004–2016), penile cancer patients of all stages were identified. Temporal trend analyses, cumulative incidence and Kaplan–Meier plots, multivariable Cox regression and Fine and Gray competing-risks regression analyses tested for CSM differences between non-SCC vs. SCC penile cancer patients. Results Of 4,120 eligible penile cancer patients, 123 (3%) harbored non-SCC vs. 4,027 (97%) SCC. Of all non-SCC patients, 51 (41%) harbored melanomas, 42 (34%) basal cell carcinomas, 10 (8%) adenocarcinomas, eight (6.5%) skin appendage malignancies, six (5%) epithelial cell neoplasms, two (1.5%) neuroendocrine tumors, two (1.5%) lymphomas, two (1.5%) sarcomas. Stage at presentation differed between non-SCC vs. SCC. In temporal trend analyses, non-SCC diagnoses neither decreased nor increased over time (p > 0.05). After stratification according to localized, locally advanced, and metastatic stage, no CSM differences were observed between non-SCC vs. SCC, with 5-year survival rates of 11 vs 11% (p = 0.9) for localized, 33 vs. 37% (p = 0.4) for locally advanced, and 1-year survival rates of 37 vs. 53% (p = 0.9) for metastatic penile cancer, respectively. After propensity score matching for patient and tumor characteristics and additional multivariable adjustment, no CSM differences between non-SCC vs. SCC were observed. Conclusion Non-SCC penile cancer is rare. Although exceptions exist, on average, non-SCC penile cancer has comparable CSM as SCC penile cancer patients, after stratification for localized, locally invasive, and metastatic disease.

Prevalence and Characteristics of Penile Cancer in Karangasem Regency, Indonesia, 2020-2022

“…Wenzel, et al, stated that this type of SCC was found more frequently. 24 A study by Zamzami, et al, in Arifin Achmad Regional General Hospital, Pekanbaru, Indonesia, also found that 100% of cases are squamous cell carcinoma. 7 While this study found 86.2% were SCC types.…”

“…It is possible that certain non-SCC types may have a less promising outcome than SCC types; penile melanoma and genitourinary sarcoma are neoplasms with a poor prognosis and have a high rate of recurrence even after surgery. 24 Carcinoma of the penis at an early stage is generally easier to treat. 4 Local therapy approaches can include penile-sparing techniques and topical chemotherapy using 5-fluorouracil and imiquimod.…”

Epidemiology of Unconventional Histological Subtypes of Urethral Cancer

“…As in all SEER-based analyses, comorbidities were not available and could lead to confounding of CSM rates. Finally, due to small sample sizes, we grouped patients within unconventional urethral-cancer histologies, as previously reported for unconventional histologies [ 30 ]. As a result, it is possible that some of these individual subtypes of unconventional histologies may have more favorable survival than others or vice versa (e.g., in lymphomas).…”

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

“…[16] Meanwhile, other studies reported differences in mortality risk between penile cancer subtypes of SCC and non-SCC, where non-SCC subtypes were associated with an increased of mortality. [21] Despite this controversy, existing studies have shown the usual SCC subtype to have a lower mortality risk than the other subtypes.…”

“…[9] Similar proportions were found in two studies that found the cancer subtype to predict mortality. [16,21] Rare cases of penile cancer other than the usual subtype of SCC cause the resulting estimate to be less accurate. More studies with larger sample sizes are needed to reach an academic consensus on the role of subtypes in the mortality prognosis of penile cancer.…”