Abstract 1311P
Background
Squamous cell penile cancer (PSCC) accounts for 140 deaths in the UK per year. Research is limited regarding the epidemiology and prevalence of risk factors amongst this cohort in the UK. We describe the epidemiology, risk factors and outcomes of a large cohort of men with PSCC treated at our centre over a 5-year period.
Methods
All men treated for PSCC to our supraregional centre between 1/2012 and 12/2017 were included. Postcodes were used to generate indices of multiple deprivation (IoMD) deciles: 1 most and 10 least deprived. Parametric tests were used to compare variables between groups. Overall survival (OS) was evaluated using Kaplan Meier methodology and Cox proportional hazards regression.
Results
325 men were included. Median age at diagnosis was 65 (range 27-96). 286 (88%) were Caucasian, 169 (52%) married and 145 (44%) lived in areas with IoMD deciles 1-3. Median BMI was 28, with 149 (46%) men being morbidly obese. 96 (29%) men had a documented history of phimosis, 12 (2.7%) of genital warts, 39 (12%) of balanitis and 13(4%) of immunosuppression. 54% of tumours tested were p16+. At diagnosis, median Charlson Co-Morbidity Index Score of men was 3 (range 0-13) and 242 men (74%) had ECOG PS of 0-1. 235 (72%) men presented with high risk tumours (T1G3,T2,T3,T4), 35 (10%) had N1 disease, 12 (4%) N2 disease, 59 (84%) N3 disease and 12 (4%) had distant metastases (M1). Compared to men in IoMD deciles 4-10, men in IoMD deciles 1-3 had more high risk tumours (67% vs 77% p=0.049) but similar rates of nodal (32% vs 34% p=0.134) and M1 disease (4.1% vs 3.4% p=0.747). At median follow up of 57.8 months, 124 (38%) men had died. 5-year OS was 69% for the entire group, 89% for N0, 71% for N1, 50% N2, 37% for N3 disease and 0% for M1 disease . Men with nodal disease had a 4 fold increased risk of death (95% CI 2.5-6.2 p<0.001) and men with M1 disease a 14.7 fold increased risk of death (95% CI 7.7-27.8 p<0.001). 5 year OS was similar between those from IoMD deciles 1-3 and IoMD 4-10 (27% versus 33% p=0.26).
Conclusions
Men with PSCC in North-West England have a high prevalence of smoking, obesity, social deprivation and HPV related tumours, however nodal involvement and M1 disease remain the most important prognostic factors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
D.M. Graham: Financial Interests, Personal, Advisory Board, Consulting role on advisory board: Clinigen; Financial Interests, Personal, Invited Speaker: Cancer Drug Development Fund; Financial Interests, Personal, Advisory Board: McCann Health; Financial Interests, Institutional, Invited Speaker, Institutional funding from study: MSD, Codiak Biosciences, Starpharma, Faron Pharmaceuticals, Synthon, Janssen; Financial Interests, Institutional, Other, Sub-I: Institutional funding from study: AstraZeneca, Roche, BerGenBio, GlaxoSmithKline, Bayer, Bicycle pharmaceuticals, Carrick, Taiho pharmaceuticals, CytomX Therapeutics, RedX Pharma PLC, Eisai Inc, Octimet, Orion Pharma, Kinex Pharmaceuticals, Boehringer Ingelheim, BMS, Turning Point Therapeutics, Immutep, Agalimmune, Kymab, Blueprint, Astellas, Cellcentric, UCB Biopharma USL, Eli Lilly, Seagen, Repare Therapeutics, Timepoint Therapeutics, Astex, Stemline, Crescendo Biologics Ltd., ADC Therapeutics, Genentech, Avacta Life Sciences Ltd., Nurix Therapeutics Inc.; Financial Interests, Institutional, Other, Sub-I: Institutional finding from study: Chugai Pharmaceuticals; Financial Interests, Institutional, Invited Speaker: Incyte. All other authors have declared no conflicts of interest.