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The study aims to evaluate the outcomes and prognostic determinants in patients undergoing multi-stage surgical treatment for penile squamous cell carcinoma.

May 14, 2026Open Access

Multi-Stage Surgical Treatment of Penile Squamous Cell Carcinoma: Primary Tumor and Nodal Management Outcomes in a Retrospective Cohort

AAAndrei Andreşanu CGConstantin Gingu MOMihaela Roxana OlițăCarol Davila University of Medicine and Pharmacy

Key Points

The study aims to evaluate the outcomes and prognostic determinants in patients undergoing multi-stage surgical treatment for penile squamous cell carcinoma.
Retrospective cohort analysis of 49 patients with penile squamous cell carcinoma treated surgically from October 2020 to December 2024.
Patients underwent bilateral inguinal femoral lymphadenectomy after curative resection of the primary tumor.
Overall survival and completion rates of treatment were the main objectives, analyzed using univariate and multivariate Cox regression.
Among 49 patients, 31 (63.3%) completed bilateral lymphadenectomy, while 18 (36.7%) did not comply with treatment.
The overall mortality rate was 55.1% with a median overall survival of 20 months.
Independent prognostic factors for overall survival included absence of lymphovascular invasion (HR 0.43, 95% CI: 0.19-0.99, p=0.048) and absence of urethral invasion (HR 0.36, 95% CI: 0.12-1.03, p=0.056).

Abstract

Introducere: Managementul chirurgical multi-stadial al carcinomului scuamos penian (CSP) presupune un proces decizional secvenial, de la tratamentul tumorii primare pn la limfadenectomia extins, aderena sczut la indicaiile terapeutice i stratificarea prognostic reprezentnd provocri clinice persistente.Studiul de fa a evaluat rezultatele i determinanii prognostici la pacienii supui tratamentului chirurgical etapizat.Materiale i Metod: Acest studiu retrospectiv de cohort a analizat 49 de pacieni cu CSP tratat chirurgical, cu indicaie pentru limfadenectomie inghino-femural bilateral (ILND) dup rezecia cu intenie curativ a tumorii primare, n perioada octombrie 2020 -decembrie 2024, ntr-un centru teriar de chirurgie oncologic din Romnia.Obiectivele principale au inclus supravieuirea global (OS), ratele de finalizare ale tratamentului i identificarea factorilor prognostici prin analiz de regresie Cox univariat i multivariat.Rezultate: Dintre cei 49 de pacieni (vrsta median 64 de ani), 31 (63,3%) au finalizat ILND bilateral n a doua etap, n timp ce 18 (36,7%) nu au fost compliani la tratament.Stadializarea patologic a relevat pN0-N1 la 36,7%, pN2 la 42,9% i pN3 la 20,4% din pacieni.Unsprezece pacieni (22,4%) au fost supui limfadenectomiei pelvine n stadiul al treilea (PLND).Mortalitatea general a atins 55,1% (27/49), cu o OS median de 20 de luni.Pacienii care au necesitat PLND n stadiul al treilea au demonstrat o mortalitate de 90,9% i o OS median de numai 12 luni.Analiza multivariat a identificat trei factori prognostici independeni pentru OS: absena invaziei limfovasculare (ILV) (HR 0,43, CI 95%: 0,19-0,99, p = 0,048), absena invaziei uretrale (HR 0,36, CI 95%: 0,12-1,03, p = 0,056) i stadiul N patologic.Fiecare ganglion limfatic

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