Lymphovascular Invasion Predicts Cancer-specific Mortality in Penile Localized Squamous Cell Carcinoma

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INTRODUCTION: Lymphovascular invasion (LVI) is a predictor of unfavorable stage at presentation in squamous cell carcinoma of the penis (SCCP). However, it is unknown if LVI may also predict cancer-specific mortality (CSM), especially in patients with localized SCCP in whom important differences in the treated natural history may exist. We addressed this knowledge gap in localized (T1b-T2N0M0) SCCP patients treated with penectomy. METHODS: Within the Surveillance, Epidemiology, and End Results database (SEER 2010-2021), we identified localized SCCP patients treated with penectomy in whom LVI status was available. Kaplan-Meier analyses and multivariable Cox regression models (CRM) addressed CSM. Covariates consisted of age at diagnosis, T stage, penectomy type, and race/ethnicity. RESULTS: Of 685 localized SCCP patients, 144 (21%) were LVI-positive. At three-years of follow-up CSM-free survival rates were 85% versus 69% in respectively LVI-negative versus LVI-positive patients (P < 0.001), which resulted in a univariable hazard ratio [HR] of 2.5 (P < 0.01). After multivariable adjustment in Cox regression models, LVI-positive status independently predicted a 2.6-fold higher CSM (P < 0.001). In subgroup analyses, LVI also independently predicted higher CSM in T1b (HR = 3.0; P = 0.01), as well as in T2 (HR= 2.5; P < 0.001) SCCP patients. CONCLUSION: In localized SCCP patients, LVI is a highly significant independent predictor of higher CSM in both T1b and T2 stages and may warrant consideration for use in clinical practice.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.