Predictors of Cancer-specific Mortality After Disease Recurrence in Patients with Squamous Cell Carcinoma of the Penis

TY - JOUR

T1 - Predictors of Cancer-specific Mortality After Disease Recurrence in Patients with Squamous Cell Carcinoma of the Penis

AU - Rieken, Malte

AU - Djajadiningrat, Rosa S

AU - Kluth, Luis A

AU - Favaretto, Ricardo L

AU - Xylinas, Evanguelos

AU - Guimaraes, Gustavo C

AU - Soares, Fernando A

AU - Kent, Matthew

AU - Sjoberg, Daniel D

AU - Horenblas, Simon

AU - Shariat, Shahrokh F

N1 - Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Disease recurrence occurs frequently after surgical treatment for squamous cell carcinoma of the penis (SCCp). We sought to determine prognostic factors that influence cancer-specific mortality (CSM) after disease recurrence in patients with SCCp. We performed a retrospective analysis of 314 patients who experienced disease recurrence after surgical treatment for SCCp between 1949 and 2012. Competing risk regression analysis addressed factors associated with CSM after SCCp recurrence. Median time from surgery to disease recurrence was 10.5 mo (interquartile range [IQR]: 5.9-21.3). Of the recurrences, 165 (53%), 118 (38%), and 31 (9.9%) were local, regional, or distant, respectively. Within a median follow-up of 4.5 yr (IQR: 2.0-6.5), 108 patients died of SCCp and 41 patients died of causes other than SCCp. Shorter time to disease recurrence was found to be significantly associated with a higher risk of CSM (p=0.0006). Lymph node metastasis at the time of initial treatment (subdistribution hazard ratio [SHR]: 1.96; 95% confidence interval [CI] 1.23- 3.11; p=0.005) and regional recurrence (SHR: 4.14; 95% CI, 2.16-7.93; p<0.0001) or distant recurrence (SHR: 5.75; 95% CI, 2.59-12.73; p<0.0001) were associated with increased risk of CSM after disease recurrence. Inclusion of time to recurrence into risk stratification may help patient counseling and treatment planning.

AB - Disease recurrence occurs frequently after surgical treatment for squamous cell carcinoma of the penis (SCCp). We sought to determine prognostic factors that influence cancer-specific mortality (CSM) after disease recurrence in patients with SCCp. We performed a retrospective analysis of 314 patients who experienced disease recurrence after surgical treatment for SCCp between 1949 and 2012. Competing risk regression analysis addressed factors associated with CSM after SCCp recurrence. Median time from surgery to disease recurrence was 10.5 mo (interquartile range [IQR]: 5.9-21.3). Of the recurrences, 165 (53%), 118 (38%), and 31 (9.9%) were local, regional, or distant, respectively. Within a median follow-up of 4.5 yr (IQR: 2.0-6.5), 108 patients died of SCCp and 41 patients died of causes other than SCCp. Shorter time to disease recurrence was found to be significantly associated with a higher risk of CSM (p=0.0006). Lymph node metastasis at the time of initial treatment (subdistribution hazard ratio [SHR]: 1.96; 95% confidence interval [CI] 1.23- 3.11; p=0.005) and regional recurrence (SHR: 4.14; 95% CI, 2.16-7.93; p<0.0001) or distant recurrence (SHR: 5.75; 95% CI, 2.59-12.73; p<0.0001) were associated with increased risk of CSM after disease recurrence. Inclusion of time to recurrence into risk stratification may help patient counseling and treatment planning.

U2 - 10.1016/j.eururo.2014.05.032

DO - 10.1016/j.eururo.2014.05.032

M3 - SCORING: Journal article

C2 - 24924553

VL - 66

SP - 811

EP - 814

JO - EUR UROL

JF - EUR UROL

SN - 0302-2838

IS - 5

ER -