Partial penectomy or total penectomy for T1 and T2 squamous cell carcinoma of the penis?

Abstract

Background: To assess prognostic factors and survival outcomes for partial penectomy (PP) and total penectomy (TP) patients with T1 and T2 squamous cell carcinoma of the penis. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify 708 penile cancer patients. Among these, 607 underwent PP and 101 underwent TP. Kaplan-Meier analysis was used to compare survival outcomes between PP and TP patients. Univariate and multivariate Cox proportional hazards regression models were used to determine prognostic factors. Results: There were significant differences in marital status and regional lymph node removal between patients of the PP and TP groups. Multivariate regression analysis demonstrated that age [odds ratio (OR) =1.045; 95% confidence interval (CI): 1.034-1.057; P<0.0001], T2 carcinoma (OR =1.388; 95% CI: 1.077-1.788; P=0.0114), node stage N1-3 (OR =3.351; 95% CI: 2.317-4.847; P<0.0001), and ≥4 regional lymph nodes removed (OR =0.498; 95% CI: 0.255-0.972; P=0.0411) were independent predictors of overall survival (OS). Age (OR =1.019; 95% CI: 1.005-1.033; P=0.0065), stage N1-3 (OR =5.127; 95% CI: 3.213-8.181; P<0.0001), and ≥4 regional lymph nodes removed (OR =0.452; 95% CI: 0.219-0.932; P=0.0315) were independent predictors of cancer specific survival (CSS). However, there was no significant difference between PP and TP in terms of OS and CSS. Conclusions: There was no significant difference in terms of OS and CSS between patients treated by PP or TP. T2 was associated with shorter OS, while age and N1-3 were associated with shorter OS and CSS. Removal of ≥4 regional lymph nodes was associated with longer OS and CSS.