Prognostic Factors in Squamous Cell Carcinoma of the Penis

Giacomo Novara; Antonio Galfano; Vincenzo De Marco; Walter Artibani; Vincenzo Ficarra

Nat Clin Pract Urol. 2007;4(3):140-146.

Natural History of Penile SCC

The clinical presentation of penile SCC is variable, and can range from an area of subtle induration to a small excrescence, papule, ulcer or a warty exophytic growth. Most commonly, those lesions arise at the glans (50%) and prepuce (20%), with a minority at the shaft. Itching or burning under the foreskin, as well as the presence of ulceration of the glans or prepuce, are the most commonly reported symptoms; the lesions are usually not particularly painful.^[3,6]

If left untreated, the disease extends along the penile shaft and involves the corpora cavernosa. As with SCC of other areas of the body, penile SCC has a particular tendency for lymphatic spread to the superficial and deep inguinal lymph nodes and, subsequently, to the pelvic nodes. Metastatic spread to distant sites (lungs, liver, bone and brain) occurs later in the natural history of the disease, and almost always after nodal spread. Without treatment, patients with penile SCC usually die within 2 years after diagnosis of the primary lesion, because of complications due to uncontrollable locoregional growth or from distant metastases.^[3,6]

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Cite this: Prognostic Factors in Squamous Cell Carcinoma of the Penis - Medscape - Mar 01, 2007.

Summary and Introduction
Natural History of Penile SCC
Prognostic Factors Predictive of LYMPH Node Involvement
Prognostic Factors Predictive of Cancer-specific Survival
Molecular Prognostic Factors
Conclusion
References
Sidebar: Key Points

Table 1. 5-year Cancer-specific Survival (% of Patients) Stratified by Clinical Lymph Nodes Stage
Study	Clinical lymph node stage^a(%)
Study	cN0	cN+	cN1	cN2	cN3
Kamat et al.(1993)^[23]	75	NR	40	39	NR
Horenblas et al.(1993)^[16]	93	50	80	50	NR
Kulkarni et al.(1994)^[24]	81	52	NR	NR	NR
Lopes et al.(1996)^[9]	56	NR	49	67	19
Villavicencio et al.(1997)^[20]	NR	NR	71	33	NR
Bezerra et al.(2001)^[18]	70	NR	71	78	34
Ficarra (unpublished data)	80	38	57	37	25

^aCancer-specific survival probabilities are expressed as percentage of patients. Abbreviations: NR = not reported.

Table 2. 5-year Cancer-specific Survival (% of Patients) Stratified by Pathological Lymph Nodes Stage
Study	Pathological lymph node stage^a(%)
Study	pN0	pN+	pN1	pN2	pN3
Srinivas et al. (1987)^[25]	85	32	NR	NR	NR
Ornellas et al. (1991)^[26]	87	29	NR	NR	NR
Horenblas et al. (1993)^[16]	100	NR	79	17	NR
Ravi (1993)^[27]	95	NR	86	60	0
Kulkarni et al. (1994)^[24]	91	NR	NR	NR	NR
Brkovic et al. (1997)^[28]	90	NR	80	NR	17
Ficarra (unpublished data)	94	29	89	7	0

^aCancer-specific survival probabilities are expressed as percentage of patients. Abbreviation: NR = not reported.

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