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Clinical Profile and Outcomes of Carcinoma Penis Patients Receiving Systemic Therapy at an Indian tertiary care
Vanita Noronha1, Venkatesh Kapu1, Amit Joshi1
1Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumai, Maharashtra, India.
Background:
Penile cancer is a rare malignancy with scant data on the impact of systemic therapy on outcomes.
Methods:
Retrospective observational study of patients with a histological diagnosis of carcinoma penis treated with systemic therapy at the Tata Memorial Centre (Mumbai, India) between August 2010 and February 2018. Primary objective was overall survival (OS); secondary objectives included assessment of clinical characteristics, treatment approaches, and toxicity profiles.
Results:
We included 91 patients with penile carcinoma who received systemic therapy at our center. Intent of therapy was curative in 71 patients (78%), and palliative in 20 (22%). Median age was 57 years (interquartile range [IQR], 50-65.5) for curatively treated patients and 58.5 years (IQR, 44-65.2) for those with advanced disease. Common presenting symptoms were lumps (70%), and pain (57%). Neoadjuvant chemotherapy (NACT) with paclitaxel + platinum was administered to 19 patients (20.9%), of which 7 (37%) attained complete or partial response. Six patients (31.5%) underwent R0 surgery post-NACT. All 71 patients underwent primary surgery; 47 (66.2%) undergoing partial penectomy. Of the 20 patients treated with palliative first-line chemotherapy, 4(20%) attained a partial response. Median OS of patients treated in curative and palliative settings was 33.8 months (95% CI, 17.2-not recorded) and 11.4 months (95% CI, 9.53-23.3), respectively.
Conclusions:
Patients with penile cancer treated with systemic therapy have poor outcomes. Little over a third of the patients respond to neoadjuvant chemotherapy and those with advanced disease have poor survival despite systemic therapy, emphasizing the need for early detection and optimum management of primary and nodal disease.
Insights
Systemic therapy offers limited benefit for penile cancer patients, with poor survival rates even in advanced stages. Early detection and optimal management are crucial for improving outcomes in this rare malignancy.
Area of Science:
- Oncology
- Medical Research
Background:
- Penile cancer is a rare malignancy with limited data on systemic therapy's impact.
- Understanding treatment outcomes is vital for improving patient care.
Purpose of the Study:
- To evaluate the overall survival (OS) of penile cancer patients receiving systemic therapy.
- To assess clinical characteristics, treatment strategies, and toxicity profiles.
Main Methods:
- Retrospective observational study of 91 penile carcinoma patients treated between August 2010 and February 2018.
- Systemic therapy included neoadjuvant chemotherapy (NACT) and palliative chemotherapy.
- Data collected on patient demographics, treatment intent, response rates, and survival.
Main Results:
- Median OS was 33.8 months for curative intent and 11.4 months for palliative intent.
- NACT response rate was 37%, with 31.5% achieving R0 resection.
- Palliative chemotherapy showed a 20% partial response rate.
Conclusions:
- Systemic therapy yields poor outcomes in penile cancer patients.
- Response to NACT is suboptimal, and advanced disease survival is poor.
- Emphasizes the need for early detection and optimal management of primary and nodal disease.
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