Predictive Factors for Local Recurrence (LR) and Cancer-Specific Survival (CSS) – an eUROGEN risk stratification for Grade 2 and Grade 3 tumours
BAUS ePoster online library. Pozzi E. 11/10/20; 304147; P6-8
Dr. Edoardo Pozzi
Dr. Edoardo Pozzi
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Predictive Factors for Local Recurrence (LR) and Cancer-Specific Survival (CSS) – an eUROGEN risk stratification for Grade 2 and Grade 3 tumours

Pozzi E1, Cakir O2, Hadway P2, Nigam R3, Freeman A3, Alnajjar H2, Muneer A2,4,5
1Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy, 2Institute of Andrology, University College London Hospital, United Kingdom, 3Department of Pathology, University College London Hospital, United Kingdom , 4NIHR Biomedical Research Centre UCLH , London, United Kingdom, 5Division of Surgery and Interventional Science UCL, London, United Kingdom

Introduction:
The 8th edition of the unified TNM staging for penile SCC considers G2 disease as intermediate risk. The aim was to analyse and compare predictors for LR and CSS between G2 and G3 tumours.

Patients and Methods:
A retrospective analysis of 494 patients treated for penile SCC between 2008 and 2019 was performed. Univariate and multivariate Cox proportional hazards regression models were used to identify predictors for LR and CSS in grade 2 and grade 3 penile SCC. Kaplan-Meier analysis displayed CSS and recurrence free survival.

Results:
Median follow-up for LR and CSS was 58 months (IQR 25-93) and 35 months (IQR 25-93) respectively. At Cox regression univariate analysis, the only predictor for LR was lymphovascular invasion (LVI) p=0.003. Predictors for CSS included LVI, peri-neural invasion (PNI), inguinal lymph node disease, extracapsular spread, distant metastatic disease, pathological T-stage (all p<0.0001) and G2 vs. G3 (p=0.003). On multivariate analysis for CSS, only ECS, LVI, pathological T-stage and metastasis were found as independent predictors for CSS (all p<0.005). At multivariate analysis for CSS, G2 vs. G3 showed a p-value of 0.48 indicating that tumour grade does not contribute significantly compared to other independent predictors for CSS and LR.

Conclusion:
G2 penile SCC outcomes are similar to G3 tumours and should be managed in the same way. Dynamic sentinel lymph node biopsy should be offered to all patients presenting with grade 2 penile SCC with clinically impalpable inguinal nodes (cN0) regardless of their T stage and histological parameters.
Predictive Factors for Local Recurrence (LR) and Cancer-Specific Survival (CSS) – an eUROGEN risk stratification for Grade 2 and Grade 3 tumours

Pozzi E1, Cakir O2, Hadway P2, Nigam R3, Freeman A3, Alnajjar H2, Muneer A2,4,5
1Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy, 2Institute of Andrology, University College London Hospital, United Kingdom, 3Department of Pathology, University College London Hospital, United Kingdom , 4NIHR Biomedical Research Centre UCLH , London, United Kingdom, 5Division of Surgery and Interventional Science UCL, London, United Kingdom

Introduction:
The 8th edition of the unified TNM staging for penile SCC considers G2 disease as intermediate risk. The aim was to analyse and compare predictors for LR and CSS between G2 and G3 tumours.

Patients and Methods:
A retrospective analysis of 494 patients treated for penile SCC between 2008 and 2019 was performed. Univariate and multivariate Cox proportional hazards regression models were used to identify predictors for LR and CSS in grade 2 and grade 3 penile SCC. Kaplan-Meier analysis displayed CSS and recurrence free survival.

Results:
Median follow-up for LR and CSS was 58 months (IQR 25-93) and 35 months (IQR 25-93) respectively. At Cox regression univariate analysis, the only predictor for LR was lymphovascular invasion (LVI) p=0.003. Predictors for CSS included LVI, peri-neural invasion (PNI), inguinal lymph node disease, extracapsular spread, distant metastatic disease, pathological T-stage (all p<0.0001) and G2 vs. G3 (p=0.003). On multivariate analysis for CSS, only ECS, LVI, pathological T-stage and metastasis were found as independent predictors for CSS (all p<0.005). At multivariate analysis for CSS, G2 vs. G3 showed a p-value of 0.48 indicating that tumour grade does not contribute significantly compared to other independent predictors for CSS and LR.

Conclusion:
G2 penile SCC outcomes are similar to G3 tumours and should be managed in the same way. Dynamic sentinel lymph node biopsy should be offered to all patients presenting with grade 2 penile SCC with clinically impalpable inguinal nodes (cN0) regardless of their T stage and histological parameters.
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