Differences in overall survival of penile cancer patients versus population‐based controls

Abstract

PurposeTo assess whether 5‐year overall survival (OS) of squamous cell carcinoma of the penis (SCCP) patients differs from age‐matched male population‐based controls.MethodsWe relied on the Surveillance Epidemiology and End Results database (2004–2018) to identify newly diagnosed (2004–2013) SCCP patients. For each case, we simulated an age‐matched control (Monte Carlo simulation), relying on the Social Security Administration (SSA) Life Tables with 5 years of follow‐up. We compared OS between SCCP patients and population‐based controls in a stage‐specific fashion. Smoothed cumulative incidence plots displayed cancer‐specific mortality (CSM) versus other‐cause mortality (OCM).ResultsOf 2282 SCCP patients, the stage distribution was as follows: stage I 976 (43%) versus stage II 826 (36%) versus stage III 302 (13%) versus stage IV 178 (8%). At 5 years, OS of SCCP patients versus age‐matched population‐based controls was as follows: stage I 63% versus 80% (Δ = 17%), stage II 50% versus 80% (Δ = 30%), stage III 39% versus 84% (Δ = 45%), stage IV 26% versus 87% (Δ = 61%). At 5 years, CSM versus OCM in SCCP patients according to stage was as follows: stage I 12% versus 24%, stage II 22% versus 28%, stage III 47% versus 14%, and stage IV 60% versus 14%.ConclusionSCCP patients exhibit worse OS across all stages. The difference in OS at 5 years between SCCP and age‐matched male population‐based controls ranged from 17% to 61%. At 5 years, CSM accounted for 12% to 60% of all deaths, across all stages.

Editorial comment on Differences in overall survival of penile cancer patients vs. population‐based controls

“…1 Published data from national databases and clinical registries have highlighted significant gaps in the diagnosis and management of penile cancer due to geographical differences in its prevalence and survival patterns, and more studies are required to comprehensively analyze specific cancer epidemiology, modify underlying risk factors, and optimize on current treatment strategies. 2 In this large-scale study using the SEER database of penile cancer analyzing newly diagnosed patients between 2004 and 2013, 3 it was found that more than two-thirds of patients (79%) presented with lower-stage cancer (stages I and II). However, the 5-year overall survival showed a worsening trend with more advanced cancer compared with age-matched population-based controls (from a 17% difference in stage I to a 61% difference in stage IV) with corresponding higher cancer-specific mortality (CSM) over other-cause mortality (OCM), especially with more advanced stages of cancer (60% vs. 14% for stage IV patients).…”