838 VALIDATION OF A NOVEL TUMOR STAGE CLASSIFICATION FOR PREDICTION OF CANCER-SPECIFIC MORTALITY IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE PENIS

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011838 VALIDATION OF A NOVEL TUMOR STAGE CLASSIFICATION FOR PREDICTION OF CANCER-SPECIFIC MORTALITY IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE PENIS Claudio Jeldres, Niels Graafland, Maxine Sun, Rodolphe Thuret, Paul Perotte, Pierre I. Karakiewicz, Joost A.P. Leijte, and Simon Horenblas Claudio JeldresClaudio Jeldres Montreal, Canada , Niels GraaflandNiels Graafland Amsterdam, Netherlands , Maxine SunMaxine Sun Montreal, Canada , Rodolphe ThuretRodolphe Thuret Montpellier, France , Paul PerottePaul Perotte Montreal, Canada , Pierre I. KarakiewiczPierre I. Karakiewicz Montreal, Canada , Joost A.P. LeijteJoost A.P. Leijte Amsterdam, Netherlands , and Simon HorenblasSimon Horenblas Amsterdam, Netherlands View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.658AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The new 2009 TNM classification for SCCP defines T2 as tumor that invades corpus spongiosum or corpora cavernosa. A modification of the current definition of the T2 category was previously suggested as it was demonstrated that the prognosis for corpus spongiosum invasion is much better than for corpora cavernosa invasion (doi: 10.1016/j.juro.2008.05.011). We tested the prognostic ability of a modified tumor stage classification relative to the existing TNM 2009. METHODS We analyzed a consecutive series of 323 patients who underwent sentinel node biopsy and/or inguinal lymphadenectomy for squamous cell carcinoma of the penis (SCCP) at a single institution. The proposed modified T category includes a change in the T2 and T3 groups (Figure). The prognostic ability of tumor stage (2009) for prediction of cancer-specific mortality (CSM) was compared to that of the proposed modified T definitions (Harrell's concordance index). RESULTS Average age was 65 years (median 66). Overall, 38% of patients had positive lymph nodes. According to the TNM 2009, 26.6, 65.0, and 8.3% of patients were T1, T2 and T3, respectively. The proportions were 26.6, 50.2, and 23.2% when the proposed T staging classification was applied. The two-year CSM-free survival rates were 90.4, 84.0, and 77.8% for T1, T2, and T3–4 (TNM 2009). The log-rank p-value comparison of T2 vs. T3–4 was 0.8. The two-year CSM-free survival rates were 90.4, 89.9, and 69.0% for T1, T2, and T3–4 (modified T). Log-rank p-value comparison of T2 vs. T3–4 was <0.001. The prognostic ability for prediction of CSM of tumor stage (TNM 2009) was 55.3% vs. 62.9% for the proposed T classification. CONCLUSIONS The prognostic ability of the proposed modified TNM staging system that discriminates between corpus spongiosum and corpus cavernosa invasion is superior to the current T classification (TNM 2009). Patients with cavernous body involvement have a substantially worse prognosis than patients with only spongious body involvement, or patients with a small distal tumor growing in the urethra. Consequently, it is important that the staging system reflects this difference. The current classification of the current T category in the TNM 2009 requires a further update. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e337 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claudio Jeldres Montreal, Canada More articles by this author Niels Graafland Amsterdam, Netherlands More articles by this author Maxine Sun Montreal, Canada More articles by this author Rodolphe Thuret Montpellier, France More articles by this author Paul Perotte Montreal, Canada More articles by this author Pierre I. Karakiewicz Montreal, Canada More articles by this author Joost A.P. Leijte Amsterdam, Netherlands More articles by this author Simon Horenblas Amsterdam, Netherlands More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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