Lymphovascular Invasion Predicts Cancer-specific Mortality in Penile Localized Squamous Cell Carcinoma
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".