CHEMOTHERAPY FOR PENIS CARCINOMA

BJU Int. 2014 Oct 7. doi: 10.1111/bju.12946. [Epub ahead of print]

Prognostic Factors Influencing Survival from Regionally Advanced Squamous Cell Carcinoma of the Penis After Preoperative Chemotherapy.

Dickstein RJ1, Munsell MF, Pagliaro LC, Pettaway CA.

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Abstract

OBJECTIVE: 

To describe both clinical and pathologic response rates, survival, and predictors of survival when utilizing contemporary peri-operative chemotherapy and surgical resection for patients with regionally advanced squamous cell carcinoma of the penis.

MATERIALS & METHODS: 

Retrospective review of all patients diagnosed with squamous cell carcinoma of the penis and regional lymph node metastases that were treated with chemotherapy with the intent to undergo lymphadenectomy. Clinical and pathologic 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: 

Sixty-one patients were identified, of which 54 (90%) received chemotherapy with paclitaxel/ifosfamide/cisplatin. Thirty-nine patients (65%) exhibited either a partial (PR) or complete response (CR) to chemotherapy. Five-year survival varied significantly (p=0.045-0.001) among patients achieving a CR/PR (50%), stable disease (25%), and progression (7.7%). Ten patients (16.4%) were rendered pN0 with combined therapy. Twenty patients (33%) were alive and disease free at a median follow-up of 67 months, while 32 (52%) died of disease. Long-term survival was associated with response to chemotherapy and favorable pathologic findings post resection.

CONCLUSION: 

Contemporary chemotherapy resulted in clinically significant responses among patients with regionally advanced penile cancer. Approximately 50% of such patients with an objective response to chemotherapy who undergo consolidative lymphadenectomy will remain alive at 5 years.