Real-world treatment outcomes of patients with penile cancer in the Kyushu-Okinawa area of Japan in the pre-guideline era

Takahiro Yamaguchi; Masato Goya; Katsuyoshi Higashijima; Shohei Tobu; Ryuta Sato; Shuichi Tatarano; Shoichiro Mukai; Kei-Ichiro Uemura; Katsunori Tatsugami; Kazuna Tsubouchi; Yohei Shida; Tatsu Ishii; Hideki Sakai; Hirofumi Matsuoka; Nobuhiro Haga; Masatoshi Eto; Tsukasa Igawa; Toshiyuki Kamoto; Hideki Enokida; Toshitaka Shin; Mitsuru Noguchi; Naohiro Fujimoto; Seiichi Saito; Tomomi Kamba

doi:10.1093/jjco/hyad053

Real-world treatment outcomes of patients with penile cancer in the Kyushu-Okinawa area of Japan in the pre-guideline era

Jpn J Clin Oncol. 2023 Aug 30;53(9):837-844. doi: 10.1093/jjco/hyad053.

Authors

Takahiro Yamaguchi¹, Masato Goya², Katsuyoshi Higashijima³, Shohei Tobu⁴, Ryuta Sato⁵, Shuichi Tatarano⁶, Shoichiro Mukai⁷, Kei-Ichiro Uemura⁸, Katsunori Tatsugami⁹, Kazuna Tsubouchi¹⁰, Yohei Shida¹¹, Tatsu Ishii¹², Hideki Sakai¹¹, Hirofumi Matsuoka¹⁰, Nobuhiro Haga¹⁰, Masatoshi Eto¹³, Tsukasa Igawa⁸, Toshiyuki Kamoto⁷, Hideki Enokida⁶, Toshitaka Shin⁵, Mitsuru Noguchi⁴, Naohiro Fujimoto³, Seiichi Saito¹⁴, Tomomi Kamba¹

Affiliations

¹ Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan.
² Department of Urology, Chubu Tokushukai Hospital, Kitanakagusuku, Okinawa, Japan.
³ Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
⁴ Department of Urology, Faculty of Medicine, Saga University, Saga, Saga, Japan.
⁵ Department of Urology, Faculty of Medicine, Oita University, Yufu, Oita, Japan.
⁶ Department of Urology, Faculty of Medicine, Kagoshima University, Kagoshima, Kagoshima, Japan.
⁷ Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan.
⁸ Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
⁹ Department of Urology, Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan.
¹⁰ Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan.
¹¹ Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
¹² Department of Urology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
¹³ Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan.
¹⁴ Department of Urology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.

PMID: 37282601
DOI: 10.1093/jjco/hyad053

Abstract

Objectives: To understand the real-world outcomes for patients with penile cancer in the Kyushu-Okinawa area before the introduction of practice guidelines in Japan.

Methods: We retrospectively collected medical information on patients with penile squamous cell carcinoma and penile intraepithelial neoplasia at 12 university hospitals and their affiliated hospitals in the Kyushu-Okinawa area from January 2009 to December 2020. Patients with unknown clinical stage were excluded. Patient background characteristics and survival, as well as pretreatment factors involved in survival, were investigated.

Results: A total of 196 patients were included. Patients with clinical stage 0, I, IIA, IIB, IIIA, IIIB and IV comprised 9.7, 26.0, 22.4, 2.6, 10.7, 14.3 and 14.3%, respectively. The median follow-up was 26 months, and the mean 5-year overall survival and cancer-specific survival rates were 74.3 and 79.8%, respectively. On univariate analysis, tumor diameter ≥ 30 mm, penile shaft tumor, Eastern Cooperative Oncology Group performance status ≥ 1, cT ≥ 3, cN ≥ 2 and cM1 were associated with significantly poorer cancer-specific survival. On multivariate analysis, pretreatment factors of cN ≥ 2 (hazard ratio, 32.5; 95% confidence interval, 5.08-208; P = 0.0002), Eastern Cooperative Oncology Group performance status ≥ 1 (4.42; 1.79-10.9; P = 0.0012) and cT ≥ 3 (3.34; 1.11-10.1; P = 0.0319) were identified as independent prognostic factors.

Conclusions: The study revealed basic data for future penile cancer treatment and research, including survival rates according to clinical stages, and identified cN ≥ 2, Eastern Cooperative Oncology Group performance status ≥ 1 and cT ≥ 3 at initial diagnosis as independent prognostic factors. Evidence for penile cancer in Japan is particularly scarce, and future large-scale prospective studies are warranted.

Keywords: penile cancer; squamous cell carcinoma; survival; treatment outcome.

MeSH terms

Humans
Japan
Male
Neoplasm Staging
Penile Neoplasms* / pathology
Penile Neoplasms* / surgery
Prognosis
Retrospective Studies
Treatment Outcome