Abstract 791P
Background
Penile cancer is a rare malignancy with incomplete data to guide therapy. Data regarding outcomes in older men, who tend to be frail, undertreated, and more prone to side effects, are limited.
Methods
Patients with malignant penile tumors diagnosed from 2004 to 2016 were identified in the Surveillance, Epidemiology and End Results Program (SEER)-18 dataset. Demographic characteristics, surgery, chemotherapy, and radiotherapy data were obtained. Population was analyzed according to age at diagnosis (<65 y vs ≥65 y). We examined univariate associations between age groups with Chi-square analysis. Kaplan-Meier curves were used for survival analysis. Univariate and multivariable hazard ratios were calculated using Cox regression. P<0.05 indicated statistical significance.
Results
We included 3784 penile cancer patients, median age was 68 y. 2222 (58.7%) of patients were ≥65 y. Older patients were more likely to be white/non-Hispanic, whereas the proportion of Hispanic patients was higher in younger patients (p<.00001). Patients ≥65 y had a lower proportion of advanced disease (stage III-IV) compared to <65 y (21.6% vs 27.3%, p=0.0007). Older patients were less likely to have received chemotherapy (6.7% vs 14.9%, p<0.0001). There was no difference in use of radiotherapy according to age (7.9% vs 9.3% p=0.11). Five-year survival in the whole population was 54.6%. Median OS in <65 y was not reached (95% CI incalculable) vs 49 m in ≥ 65 y (95% CI 45-53, p <0.0001). OS was different by age groups when stratified by clinical stage at diagnosis. Median OS in <65 was not reached in stages I-III and 13 m in stage IV disease. In ≥65 stage I median OS was not reached, 43 m in stage II, 32 m in stage III and 9 m in stage IV (p<0.0001). Median cancer specific survival (CSS) was not reached in <65 y for stages I-III and 16 m for stage IV; for ≥65, it was not reached in stages I-III and 15 m in stage IV (p <0.0001). Median OS in those who received chemotherapy was lower in older men (21 vs 38 m, p = 0.0063).
Conclusions
Median OS and CSS are lower in older penile cancer patients, factors potentially associated are undertreatment. These data highlight the importance of timely evaluation of clinical signs and symptoms of penile cancer in geriatric populations and the need for novel approaches.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Thomas Flaig.
Funding
University of Colorado.
Disclosure
M.T. Bourlon: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: BMS; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Asofarma; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: MSD; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Bayer; Honoraria (self), Honoraria (institution), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Janssen; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Travel/Accommodation/Expenses: Ipsen. H.C. Verduzco-Aguirre: Travel/Accommodation/Expenses: BMS. T. Flaig: Leadership role, Shareholder/Stockholder/Stock options: Aurora Oncology; Honoraria (self): BN Immuno Therapeutics; Advisory/Consultancy, Research grant/Funding (self): GTX; Research grant/Funding (self): Novartis; Research grant/Funding (self): Bavarian Nordic; Research grant/Funding (self): Dendreon; Research grant/Funding (self): Janssen Oncology; Research grant/Funding (self): Medivation; Research grant/Funding (self): Sanofi; Research grant/Funding (self): Pfizer; Research grant/Funding (self): Bristol-Myers Squibb; Research grant/Funding (self): Roche/Genetech; Research grant/Funding (self): Exelixis; Research grant/Funding (self): Aragon Pharmaceuticals; Research grant/Funding (self): Sotio; Research grant/Funding (self): Tokai Pharmaceutical; Research grant/Funding (self): AstraZeneca/MedImmune; Research grant/Funding (self): Lilly; Research grant/Funding (self): Astellas Pharma; Research grant/Funding (self): Agensys; Research grant/Funding (self): Seattle Genetics; Research grant/Funding (self): La Roche-Posay; Research grant/Funding (self): Merck. All other authors have declared no conflicts of interest.