A Risk Calculator Predicting Recurrence in Lymph Node Metastatic Penile Cancer

OBJECTIVES To date, no validated prognostic tool is available in patients with penile squamous cell carcinoma (pSCC) and inguinal lymph node metastases (ILNM). We aimed to develop and externally validate a risk calculator for prediction of any cancer recurrence in ILNM pSCC patients. MATERIALS AND METHODS The development cohort included 234pts from 7 referral centers. The external validation cohort included 273pts from 2 additional referral centers. Cox regression identified predictors of any recurrence, which were used to develop a risk calculator. The risk-calculator grouped the development and the validation cohorts according to the individual risk of any recurrence at 24 months (24m-R). Adjuvant treatment effects were tested on overall survival (OS) according to the derived tertiles, within the development and validation cohorts. RESULTS Positive surgical margins, pN3 , and ILNM ratio were associated with higher recurrence rate. Two-year OS rates were lower for patients with high (>37%) and intermediate (19-37%) compared to low ( 0.1). CONCLUSION Adjuvant treatment planning is crucial in patients with lymph node metastatic penile cancer, where only weak evidences are available. The current tool proved to successfully stratify patients according to their individual risk, potentially allowing better tailoring of adjuvant treatments.