Login to Access Video or Poster Abstract: MP69-09
Sources of Funding: None

Introduction

In the United States, the most common presentation for penile cancer (PC) is a distal, organ confined squamous cell cancer. Traditional treatment of PC in the form of total penectomy (TP) carries devastating functional and psychological outcomes. There is evidence that organ sparing surgery (OSS) has a higher rate of recurrence though that may not impact survival. We utilize the national cancer database to asses for a difference in survival among the different surgical options commonly used to treat T1/T2 penile cancer.

Methods

Patients underwent OSS, partial penectomy (PP) and TP were identified. Demographic data including differences among the 3 groups were assessed using Chi-square test. Survival estimates were assessed using Kaplan-Meier estimate.

Results

Between 2004 and 2014, 1,539 patients underwent surgery for T1/T2 penile cancer. There were 477 patients in the OSS group, 802 in the PP group and 202 in the TP group. Mean follow up in months was 44.6, 41.6 and 38.4 in the OSS, PP and TP groups respectively (p=0.002). There was no difference in age or racial distribution among the 3 groups (p=0.75 and 0.54 respectively). Overall, the three groups were more likely to receive treatment in an academic center, Medicare was the prevailing insurance type and most patients reside in Urban areas (p=<0.001, <0.001 and 0.04 respectively). The incidence of T1/T2 in the OSS, PP and TP groups were 85.9/14.1, 39.8/50.2 and 37.7/62.3 respectively (p= <0.001). The 1,5 and 10 years survival rates for the 3 groups is illustrated in Table 1. Predictors of poor survival were older age, black race and T2 disease. The type of surgery offered was not predictor of poor survival.

Conclusions

In the early stage penile cancer, which is the most common presenting stage in the United States, the degree of aggressiveness of initial surgical treatment did not alter the long term patient survival. Consideration for penile organ sparing surgery, which has better functional and psychological outcomes, should always be discussed with the patient.

Funding

None