Penile Squamous Cell Carcinoma Clinicopathological Features, Nodal Metastasis and Outcome in 333 Cases

Hospital do Cancer A. C. Camargo, São Paulo, Brazil.
The Journal of urology (Impact Factor: 4.47). 07/2009; 182(2):528-34; discussion 534. DOI: 10.1016/j.juro.2009.04.028
Source: PubMed


We evaluated clinicopathological features and outcomes in patients with penile squamous cell carcinoma.
We studied 333 patients with homogeneous surgical treatment, including circumcision in 4, local excision in 2, partial penectomy in 194 and total penectomy in 133. Of the patients 153 also underwent bilateral groin dissection. Followup was 8 to 453 months (average 100).
The usual type of squamous cell carcinoma was noted in 65% of cases. Higher histological grade, deeper anatomical infiltration, and vascular and perineural invasion were common findings in sarcomatoid, basaloid and adenosquamous carcinoma cases, correlating with a higher rate of nodal metastasis and mortality. These features were unusual in verrucous, papillary and warty carcinoma cases. Recurrence in 22% of cases was common for the sarcomatoid, basaloid and adenosquamous types but was not noted for verrucous carcinoma. Locoregional relapse was more common in cases of usual, mixed, papillary and warty carcinoma, and systemic relapse was typical in sarcomatoid and basaloid carcinoma cases. The overall metastasis rate was 24% and the 10-year survival rate was 82%. The highest mortality rate was observed within the first 3 years of followup. High grade tumors were more common in penectomy cases and carcinoma exclusive of the foreskin had a better prognosis. The nodal metastasis risk groups were low--verrucous, papillary and warty, intermediate--usual and mixed, and high risk--sarcomatoid, basaloid and adenosquamous. Mortality risk groups were low--mixed, papillary and warty, intermediate--usual and basaloid, and high risk--sarcomatoid.
These data should help clinicians to design therapeutic strategies and followup protocols.

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    • "In addition, to consider only the T stage of the penile tumor to define the type and extension of primary treatment could be misleading. Some tumor variants, such as basaloid, sarcomatoid and high-grade usual carcinomas are intrinsically aggressive, regardless of the anatomical level of infiltration (Chaux et al. 2009; Velazquez et al. 2005; Guimarães et al. 2009). Other tumor variants, such as carcinoma cuniculatum, could invade deep erectile "
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    SpringerPlus 12/2015; 4(1):248. DOI:10.1186/s40064-015-1035-2
    • "It accounts for <1% of cancers in males. It is more common in 6th and 7th decade.[5] "
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    • "Guimarães et al.,[9] have documented a 10% recurrence rate for WC when compared to 28% for SC-NOS. The follow-up in our series was not complete. "
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    ABSTRACT: There are few studies on the pathology of warty carcinoma (WC) of the penis and these have been from South America. Penile cancers are not uncommon in India. We reviewed the frequency of subtypes of penile squamous carcinoma (SC) and the pathological features and outcome of WC when compared to squamous carcinoma-not otherwise specified (SC-NOS). We also compared the clinicopathological features of WC in our series with those published earlier. We studied 103 cases of penile cancers over 6 years. Cases were classified into different subtypes according to established histologic criteria. Clinicopathologic features were studied in detail and compared among the different subtypes, especially between WC and SC-NOS. The patients were followed-up and disease free survival in months was noted. SC-NOS constituted 75.7% of all penile cancer cases in our series. The frequency of other subtypes was WC: 9.7%, verrucous: 3.9%, basaloid type and papillary type: 0.97% each, and mixed types 8.7%. The average tumor size and depth of invasion did not differ significantly between the two subtypes. Frequency of lymphovascular emboli and percentage of lymph node metastasis in WC (30 and 10%) were lesser than in SC-NOS (49.37 and 26.58%), respectively. There were no recurrences after partial penectomy in the WC subtype. In the SC-NOS type, three cases had recurrence after partial/total penectomy. Warty carcinoma constitutes nearly 10% of all penile squamous cell cancers. These patients seem to have a less aggressive behavior than SC-NOS.
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