Outcomes of penile sarcomatoid squamous cell carcinoma from a single tertiary referral centre: a matched cohort study

Karl H Pang; Benedict Girling; Elizabeth Osinibi; Paramvir Sawhney; Aiman Haider; Alex Freeman; Paul Hadway; Raj Nigam; Rowland Rees; Anita Mitra; Asif Muneer; Constantine Alifrangis; Hussain M Alnajjar

doi:10.1111/bju.16044

Outcomes of penile sarcomatoid squamous cell carcinoma from a single tertiary referral centre: a matched cohort study

BJU Int. 2023 Sep;132(3):337-342. doi: 10.1111/bju.16044. Epub 2023 Jun 1.

Authors

Karl H Pang^{1

2}, Benedict Girling³, Elizabeth Osinibi¹, Paramvir Sawhney³, Aiman Haider⁴, Alex Freeman⁴, Paul Hadway^{1

5}, Raj Nigam^{1

6}, Rowland Rees^{1

7}, Anita Mitra⁸, Asif Muneer^{1

9

2

10}, Constantine Alifrangis³, Hussain M Alnajjar^{1

2}

Affiliations

¹ Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK.
² Division of Surgery and Interventional Science, University College London, London, UK.
³ Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
⁴ Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK.
⁵ Department of Urology, Royal Berkshire NHS Foundation Trust, Reading, UK.
⁶ Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK.
⁷ Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
⁸ Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
⁹ NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK.
¹⁰ Department of Surgical Biotechnology, University College London, London, UK.

PMID: 37169730
DOI: 10.1111/bju.16044

Abstract

Objective: To report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC).

Patients and methods: A retrospective analysis of men with penile sSCC diagnosed between January 2010 and January 2020 in a single centre was conducted. Disease-specific (DSS), recurrence-free (RFS) and metastasis-free (MFS) survival were evaluated. Outcomes were compared with a non-sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan-Meier plots were used to estimate survival outcomes.

Results: In all, 1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (interquartile range) age and follow-up was 70 (57-81) years and 16 (7-44) months, respectively. Operations performed included: circumcision, one (2.6%); wide local excision, four (10.5%); glansectomy, 11 (29%); partial penectomy, 10 (26%); subtotal/total penectomy, 12 (32%). The Kaplan-Meier estimated 12-, 24- and 36-month DSS was 62% (vs non-sarcomatoid, 67%), 43% (vs non-sarcomatoid, 67%) and 36% (vs non-sarcomatoid, 67%), respectively (P = 0.03). The Kaplan-Meier estimated 12- and 24-month RFS was 47% (vs non-sarcomatoid, 60%) and 28% (vs non-sarcomatoid, 55%), respectively (P = 0.01). The MFS was 52% (vs non-sarcomatoid, 62%) at 12 months and 37% (vs non-sarcomatoid, 57%) at 24 months (P = 0.04).

Conclusions: Sarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.

Keywords: oncological outcomes; penile cancer; sarcomatoid; squamous cell carcinoma; urogenital cancer.