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Penile squamous cell carcinoma clinicopathological features, nodal metastasis and outcome in 333 cases
The Journal of Urology, 07/20/09

Guimaraes GC et al. - In a study to evaluate clinicopathological features and outcomes in pts with penile squamous cell carcinoma, study data should help clinicians to design therapeutic strategies and followup protocols.

Methods

333 pts with homogeneous surgical treatment were studied, including circumcision in 4, local excision in 2, partial penectomy in 194, and total penectomy in 133.
Of the pts, 153 also underwent bilateral groin dissection.
Followup was 8 to 453 mos (average 100).

Results

The usual type of squamous cell carcinoma was noted in 65% of cases.
Higher histological grade, deeper anatomical infiltration, and vascular and perineural invasion were common findings in sarcomatoid, basaloid ,and adenosquamous carcinoma cases, correlating with a higher rate of nodal metastasis and mortality.
These features were unusual in verrucous, papillary, and warty carcinoma cases.
Recurrence in 22% of cases was common for the sarcomatoid, basaloid, and adenosquamous types but was not noted for verrucous carcinoma.
Locoregional relapse was more common in cases of usual, mixed, papillary, and warty carcinoma; and systemic relapse was typical in sarcomatoid and basaloid carcinoma cases.
Overall metastasis rate was 24% and the 10-yr survival rate was 82%.
Highest mortality rate was observed within the first 3 yrs of followup.
High-grade tumors were more common in penectomy cases and carcinoma exclusive of the foreskin had a better prognosis.
Nodal metastasis risk groups were low—verrucous, papillary and warty, intermediate—usual and mixed, and high risk—sarcomatoid, basaloid and adenosquamous.
Mortality risk groups were low—mixed, papillary and warty, intermediate—usual and basaloid, and high risk—sarcomatoid.

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