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Patients with penile squamous cell carcinoma after regional lymphadenectomy: prognostic factors of adjuvant taxane, Cisplatin, and 5-Fluorouracil chemotherapy


Little is known about the outcomes and prognostic factors of adjuvant chemotherapy for locally advanced penile squamous cell carcinoma after regional lymphadenectomy ( LAD ).

Researchers have retrospectively reviewed the data from 21 patients who had received taxane, Cisplatin, and 5-Fluorouracil ( TPF, every 3 weeks ) in the adjuvant setting.

The patients had received taxane, Cisplatin, and 5-Fluorouracil from July 2004 to July 2012 after inguinal ( n=6 ) or inguinal plus pelvic lymphadenectomy ( n=15 ), and the median follow-up was 52 months.

Thirteen ( 61.9% ) had pelvic and 5 ( 23.8% ) bilateral inguinal nodal metastases.

The median time from lymphadenectomy to the start of taxane, Cisplatin, and 5-Fluorouracil was 5.4 weeks ( interquartile range [ IQR ], 4.1-7.3 weeks ).

Metastatic tumor tissue from 11 of 19 evaluable patients ( 57.9% ) showed positive immunohistochemistry staining for p53.

Univariably, only the expression of p53 showed a trend toward poorer disease-free survival ( hazard ratio [ HR ], 4.14; 95% confidence interval [ CI ], 0.87-19.68; P = .074 ) and overall survival ( HR, 4.54; 95% CI, 0.95-21.56; P = 0.056 ).

The same results were obtained multivariably for disease-free survival ( HR, 3.76; 95% CI, 0.78-17.96; P = 0.096 ) and overall survival ( HR, 4.29; 95% CI, 0.89-20.57; P = 0.067 ).
The median disease-free survival was 8.9 months ( IQR, 5.9-22.7 months ) for p53-expressing patients versus not estimable for non-p53-expressing patients ( P = 0.051 ) and the median overall survival was 17.2 months ( IQR, 12.8-22.7 months ) and not estimable, respectively ( P = 0.037 ).

In conclusion, in patients who had received adjuvant taxane, Cisplatin, and 5-Fluorouracil for node-positive penile squamous cell carcinoma, p53 IHC expression seemed to be associated with a poorer outcome, and further study is warranted in larger data sets to confirm these findings. This information might be useful to improve the prognostic allocation. ( Xagena )

Necchi A et al, Clin Genitourin Cancer 2016; Epub ahead of print

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