TY - JOUR
T1 - Clinical Outcomes of Perioperative Chemotherapy in Patients With Locally Advanced Penile Squamous-Cell Carcinoma
T2 - Results of a Multicenter Analysis
AU - Necchi, Andrea
AU - Pond, Gregory R.
AU - Raggi, Daniele
AU - Ottenhof, Sarah R.
AU - Djajadiningrat, Rosa S.
AU - Horenblas, Simon
AU - Khoo, Vincent
AU - Hakenberg, Oliver W.
AU - Draeger, Desiree
AU - Protzel, Chris
AU - Heidenreich, Axel
AU - Haidl, Friederike
AU - Eigl, Bernie J.
AU - Nappi, Lucia
AU - Matsumoto, Kazumasa
AU - Vaishampayan, Ulka
AU - Woods, Michael E.
AU - Salvioni, Roberto
AU - Nicolai, Nicola
AU - Catanzaro, Mario
AU - Giannatempo, Patrizia
AU - Geynisman, Daniel M.
AU - Preto, Mirko
AU - Xylinas, Evanguelos
AU - Milowsky, Matthew I.
AU - De Placido, Sabino
AU - Di Lorenzo, Giuseppe
AU - Sonpavde, Guru
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/10
Y1 - 2017/10
N2 - Patients with locally advanced penile squamous-cell carcinoma have a poor prognosis. No difference in survival was noted when using chemotherapy before or after surgery. Uncertainties persist regarding the optimal management of these patients, and new treatments are urgently required, particularly for patients at highest risk, with bilateral and/or pelvic lymph node involvement. Background The prognosis of patients with locally advanced penile squamous-cell carcinoma is primarily related to the extent of lymph node metastases. Surgery alone yields suboptimal results, and there is a paucity of data on these patients' outcomes. Patients and Methods This retrospective study evaluated patients who received neoadjuvant or adjuvant chemotherapy from 1990 onward at 12 centers. Cox models were used to investigate prognostic factors for relapse-free survival and overall survival (OS). Results Among the 201 included patients, 39 (19.4%) had disease of T3-4 and N0 clinical stage; the remaining patients had clinical lymph node involvement (cN+). Ninety-four patients received neoadjuvant chemotherapy (group 1), 78 received adjuvant chemotherapy (group 2), and 21 received both (group 3). Eight patients for whom the timing of perioperative chemotherapy administration was unavailable were included in the Cox analyses. Forty-three patients (21.4%) received chemoradiation. Multivariate analysis for OS (n = 172) revealed bilateral disease (P = .035) as a negative prognostic factor, while pelvic cN+ tended to be nonsignificantly associated with decreased OS (P = .076). One-year relapse-free survival was 35.6%, 60.6%, and 45.1% in the 3 groups, respectively. One-year OS was 61.3%, 82.2%, and 75%, respectively. No significant differences were seen on univariable analyses for OS between the groups (P = .45). Platinum type of chemotherapy and chemoradiation were not significantly associated with any outcome analyzed. Conclusion Benchmark survival estimates for patients receiving perioperative chemotherapy for locally advanced penile squamous-cell carcinoma have been provided, with no substantial differences observed between neoadjuvant and adjuvant administration. This analysis may result in improved patient information, although prospective studies are warranted.
AB - Patients with locally advanced penile squamous-cell carcinoma have a poor prognosis. No difference in survival was noted when using chemotherapy before or after surgery. Uncertainties persist regarding the optimal management of these patients, and new treatments are urgently required, particularly for patients at highest risk, with bilateral and/or pelvic lymph node involvement. Background The prognosis of patients with locally advanced penile squamous-cell carcinoma is primarily related to the extent of lymph node metastases. Surgery alone yields suboptimal results, and there is a paucity of data on these patients' outcomes. Patients and Methods This retrospective study evaluated patients who received neoadjuvant or adjuvant chemotherapy from 1990 onward at 12 centers. Cox models were used to investigate prognostic factors for relapse-free survival and overall survival (OS). Results Among the 201 included patients, 39 (19.4%) had disease of T3-4 and N0 clinical stage; the remaining patients had clinical lymph node involvement (cN+). Ninety-four patients received neoadjuvant chemotherapy (group 1), 78 received adjuvant chemotherapy (group 2), and 21 received both (group 3). Eight patients for whom the timing of perioperative chemotherapy administration was unavailable were included in the Cox analyses. Forty-three patients (21.4%) received chemoradiation. Multivariate analysis for OS (n = 172) revealed bilateral disease (P = .035) as a negative prognostic factor, while pelvic cN+ tended to be nonsignificantly associated with decreased OS (P = .076). One-year relapse-free survival was 35.6%, 60.6%, and 45.1% in the 3 groups, respectively. One-year OS was 61.3%, 82.2%, and 75%, respectively. No significant differences were seen on univariable analyses for OS between the groups (P = .45). Platinum type of chemotherapy and chemoradiation were not significantly associated with any outcome analyzed. Conclusion Benchmark survival estimates for patients receiving perioperative chemotherapy for locally advanced penile squamous-cell carcinoma have been provided, with no substantial differences observed between neoadjuvant and adjuvant administration. This analysis may result in improved patient information, although prospective studies are warranted.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Carcinoma, Squamous Cell/drug therapy
KW - Chemoradiotherapy
KW - Chemotherapy, Adjuvant/methods
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoadjuvant Therapy/methods
KW - Penile Neoplasms/drug therapy
KW - Perioperative Period
KW - Prognosis
KW - Prospective Studies
KW - Survival Analysis
KW - Treatment Outcome
UR - http://www.scopus.com/inward/record.url?scp=85015314977&partnerID=8YFLogxK
U2 - 10.1016/j.clgc.2017.02.002
DO - 10.1016/j.clgc.2017.02.002
M3 - Article
C2 - 28325636
AN - SCOPUS:85015314977
SN - 1558-7673
VL - 15
SP - 548-555.e3
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 5
ER -