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Local Tumor Destruction Versus Partial Penectomy for T1a Squamous Cell Carcinoma of the Penis
Letizia Maria Ippolita Jannello1,2,3, Mario de Angelis4,5,6, Carolin Siech4,7
1Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada. letizia.jannello@unimi.it.
Background:
Local tumor destruction (LTD) represents a relatively novel approach for the management of early-stage squamous cell carcinoma of the penis (SCCP). Its cancer control efficacy has never been tested in large-scale epidemiologic studies. We addressed this knowledge gap and tested for differences in cancer-specific mortality (CSM) between LTD versus partial penectomy (PP) in T1aN0M0 SCCP.
Methods:
Within the Surveillance, Epidemiology, and End Results database (2000-2020), we identified T1aN0M0 SCCP patients treated with LTD or PP. Cumulative incidence plots as well as multivariable competing risks regression models addressed CSM. Additional accounting was made for the confounding effect of other-cause mortality.
Results:
Of 1,239 patients with T1aN0M0 SCCP, 615 (49.6%) underwent LTD versus 624 (50.4%) PP. The majority of patients were Caucasian in LTD 393 (63.9%) and in PP 406 (65.1%) groups. Local tumor destruction patients were young (median age 65 versus 70 years). In cumulative incidence plots, 10-year CSM was 12.4% in LTD versus 13.5% in PP SCCP patients (p = 0.8). In multivariable competing risks regression models, LTD did not independently predict higher CSM relative to PP (hazard ratio 0.99; p = 0.97).
Conclusions:
In this large population-based cohort of T1a SCCP patients, the rate of LTD virtually perfectly approximated that of PP. Local tumor destruction patients exhibited virtually the same cancer-control outcomes as their PP counterparts. In consequence, LTD may be considered a safe alternative to PP in T1aN0M0 SCCP based on cancer-control outcomes.
Insights
Local tumor destruction (LTD) offers similar cancer-specific survival as partial penectomy (PP) for early-stage penile cancer. This study found LTD to be a safe and effective alternative for T1aN0M0 squamous cell carcinoma of the penis (SCCP).
Area of Science:
- Oncology
- Surgical Oncology
- Epidemiology
Background:
- Local tumor destruction (LTD) is an emerging treatment for early penile cancer.
- Its efficacy compared to standard treatments like partial penectomy (PP) is not well-established in large studies.
- This study investigates the cancer control outcomes of LTD versus PP in T1aN0M0 squamous cell carcinoma of the penis (SCCP).
Purpose of the Study:
- To compare cancer-specific mortality (CSM) between LTD and PP for T1aN0M0 SCCP.
- To evaluate the safety and efficacy of LTD as an alternative treatment option.
- To address the knowledge gap regarding LTD's effectiveness in large-scale studies.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database (2000-2020).
- Identified patients with T1aN0M0 SCCP treated with either LTD or PP.
- Employed cumulative incidence plots and multivariable competing risks regression models, adjusting for other-cause mortality.
Main Results:
- Analyzed 1,239 patients: 615 (49.6%) received LTD and 624 (50.4%) received PP.
- 10-year CSM was comparable: 12.4% for LTD versus 13.5% for PP (p=0.8).
- LTD was not an independent predictor of higher CSM compared to PP (HR 0.99, p=0.97).
Conclusions:
- LTD demonstrated comparable cancer-specific mortality rates to PP in T1aN0M0 SCCP.
- The study supports LTD as a safe alternative to PP based on cancer control outcomes.
- LTD may be a viable option for managing early-stage penile cancer.
