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Bejrananda T, Pinkheaw N, Sathitruangsak C, Tanthanuch M. Enhanced Prognostic Factors for Disease-Free Survival in Penile Squamous Cell Carcinoma: Insights From Songklanagarind Hospital. Clin Genitourin Cancer 2024; 22:102117. [PMID: 38820999 DOI: 10.1016/j.clgc.2024.102117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE This study aimed to investigate disease-free survival (DFS) outcomes and associated prognostic factors among surgically treated penile cancer patients at Songklanagarind Hospital, Thailand, over a 20-year period. METHODS A retrospective analysis was conducted on 208 primary penile cancer patients treated between January 2001 and December 2022. Disease-free survival was assessed using Kaplan-Meier survival curves, and Cox proportional hazard models were employed for multivariate analysis. RESULTS All of patients (100%) were squamous cell carcinoma of penis, with 38.9% having T1 tumors, 70.7% well-differentiated tumors, and 32.6% diagnosed at stage III. The recurrence rate was 16.8%, with a mean time to recurrence of 25.9 months. Disease-free survival rates at 1, 3, and 5 years were 82.1%, 72%, and 70.2%, respectively. Median overall survival was 18.2 months, with rates at 1, 3, and 5 years at 68.7%, 44.7%, and 36.4%, respectively. Significant associations were found between disease-free survival and higher T stage, clinical chronic inflammation, delayed onset of symptoms, primary lesion location, groin node metastasis, lymphovascular invasion, and pelvic lymph node metastases. However, multivariate analysis revealed that higher primary tumor stage (T) was the only independent prognostic factor for disease-free survival. CONCLUSION This study provides valuable insights into disease-free survival outcomes in penile cancer treatment at a single institution over an extended period. Higher pathologic T stage emerged as the sole independent prognostic factor for disease-free survival. Further validation through large-scale prospective studies is warranted.
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Affiliation(s)
- Tanan Bejrananda
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
| | - Natthakan Pinkheaw
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Chirawadee Sathitruangsak
- Holistic Center for Cancer Study and Care (HOCC-PSU) and Medical Oncology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Monthira Tanthanuch
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Li K, Zhang K, Yuan H, Fan C. Prognostic role of primary tumor size in Wilms tumor. Oncol Lett 2024; 27:164. [PMID: 38426157 PMCID: PMC10902748 DOI: 10.3892/ol.2024.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
Wilms tumor (WT) is the most common childhood malignant kidney tumor. The aim of the present study was to determine the impact of primary tumor size on the survival of patients with WT. The data of 1,523 patients diagnosed with WT between 2000 and 2017 were retrieved from the Surveillance, Epidemiology, and End Results database. Receiver operating characteristic curves were plotted to determine the optimal cut-off value of primary tumor size. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method and the Cox proportional hazards regression model. The optimal cut-off value for primary tumor size was found to be 11.15 cm. No significant difference in the distribution of tumor size was detected between male and female patients. However, lymph node metastasis and distant metastasis were significantly more frequent in patients whose tumor was ≥11.15 cm in size compared with those with smaller tumors. In addition, patients with larger tumors exhibited significantly worse OS and CSS rates compared with those with smaller tumors. Furthermore, primary tumor size was identified as an independent prognostic factor for OS and CSS in the multivariate analyses. In summary, the present study indicates that primary tumor size is an independent prognostic factor for patients with WT, and tumors ≥11.15 cm are associated with worse OS and CSS.
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Affiliation(s)
- Kai Li
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu 215000, P.R. China
| | - Ke Zhang
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu 215000, P.R. China
| | - Hexing Yuan
- Department of Urology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, P.R. China
| | - Caibin Fan
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu 215000, P.R. China
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Pinkheaw N, Sathitruangsak C, Tanthanuch M, Bejrananda T. Real world data of recurrent and survival rates of penile cancer patients in Songklanagarind hospital: Tumor stage as a predictor for disease-free survival. Int J Urol 2024; 31:144-153. [PMID: 37846171 DOI: 10.1111/iju.15326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE This study investigated disease-free survival and oncological outcomes in penile cancer patients treated surgically at a high-volume center and identified the prognostic factors for disease-free survival. METHODS A retrospective analysis was conducted on primary penile cancer patients diagnosed and treated at Songklanagarind Hospital, Thailand, between January 2001 and December 2021. Disease-free survival (DFS) was assessed using Kaplan-Meier survival curves, and Cox proportional hazard models were used for multivariate analysis. RESULTS The study included 188 patients with primary penile cancer. The majority (98.4%) were uncircumcised. Tumor staging revealed 40.6% with T1 tumors, 72.9% with well-differentiated tumors, and 23.5% diagnosed at stage IIIA. The recurrence rate was 19.1%, with a mean time to recurrence of 25.9 months. Disease-free survival rates at 1, 3, and 5 years were 81.1%, 70.9%, and 70.9%, respectively. Median overall survival was 16.43 months, with survival rates at 1, 3, and 5 years at 67.7%, 42.7%, and 35.4%, respectively. Cox proportional hazard models showed significant associations between disease-free survival and a higher T stage, a high level of CRP (>15 mg/L), delayed onset of symptoms, primary lesion location, groin node metastasis, lymphovascular invasion, and pelvic lymph node metastases. However, multivariate analysis revealed that a higher primary tumor stage (T) was the only independent prognostic factor for disease-free survival. CONCLUSION This study presents one of the largest cohorts investigating disease-free survival outcomes in penile cancer treatment at a single institution over a prolonged period. A higher pathologic T stage is a significant prognostic factor for disease-free survival. Further large-scale prospective studies are needed for validation.
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Affiliation(s)
- Natthakan Pinkheaw
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Chirawadee Sathitruangsak
- Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, Prince of Songkla University, Songkhla, Hat Yai, Thailand
| | - Monthira Tanthanuch
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Tanan Bejrananda
- Division of Urology, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Chen D, Liang S, Chen J, Li K, Mi H. Machine learning-based overall and cancer-specific survival prediction of M0 penile squamous cell carcinoma:A population-based retrospective study. Heliyon 2024; 10:e23442. [PMID: 38163093 PMCID: PMC10755306 DOI: 10.1016/j.heliyon.2023.e23442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Background Penile cancer is a rare tumor and few studies have focused on the prognosis of M0 penile squamous cell carcinoma (PSCC). This retrospective study aimed to identify independent prognostic factors and construct predictive models for the overall survival (OS) and cancer-specific survival (CSS) of patients with M0 PSCC. Methods Data was extracted from the Surveillance, Epidemiology, and End Results database for patients diagnosed with malignant penile cancer. Eligible patients with M0 PSCC were selected according to predetermined inclusion and exclusion criteria. These patients were then divided into a training set, a validation set, and a test set. Univariate and multivariate COX regression analyses were initially performed to identify independent prognostic factors for OS and CSS in M0 PSCC patients. Subsequently, traditional and machine learning prognostic models, including random survival forest (RSF), COX, gradient boosting, and component-wise gradient boosting modelling, were constructed using the scikit-survival framework. The performance of each model was assessed by calculating time-dependent area under curve (AUC), C-index, and integrated Brier score (IBS), ultimately identifying the model with the highest performance. Finally, the Shapley additive explanation (SHAP) value, feature importance, and cumulative rates analyses were used to further estimate the selected model. Results A total of 2, 446 patients were included in our study. Cox regression analyses demonstrated that age, N stage, and tumor size were predictors of OS, while the N stage, tumor size, surgery, and residential area were predictors of CSS. The RSF and COX models had a higher time-independent AUC and C-index, and lower IBS value than other models in OS and CSS prediction. Feature importance analysis revealed the N stage as a common significant feature for predicting M0 PSCC patients' survival. The SHAP and cumulative rate analyses demonstrated that the selected models can effectively evaluate the prognosis of M0 PSCC patients. Conclusion In M0 PSCC patients, age, N stage, and tumor size were predictors of OS. In addition, the N stage, tumor size, surgery, and residential area were predictors of CSS. The machine learning-based RSF and COX models effectively predicted the prognosis of M0 PSCC patients.
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Affiliation(s)
| | | | | | - Kezhen Li
- Department of urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, China
| | - Hua Mi
- Department of urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, China
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Cappello A, Zuccotti A, Mancini M, Tosetti G, Fania L, Ricci F, Melino G, Candi E. Serine and one-carbon metabolism sustain non-melanoma skin cancer progression. Cell Death Discov 2023; 9:102. [PMID: 36964165 PMCID: PMC10039038 DOI: 10.1038/s41420-023-01398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/26/2023] Open
Abstract
Non-melanoma skin cancer (NMSC) is a tumor that arises from human keratinocytes, showing abnormal control of cell proliferation and aberrant stratification. Cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) are the most common sub-types of NMSC. From a molecular point of view, we are still far from fully understanding the molecular mechanisms behind the onset and progression of NMSC and to unravel targetable vulnerabilities to leverage for their treatment, which is still essentially based on surgery. Under this assumption, it is still not elucidated how the central cellular metabolism, a potential therapeutical target, is involved in NMSC progression. Therefore, our work is based on the characterization of the serine anabolism/catabolism and/or one-carbon metabolism (OCM) role in NMSC pathogenesis. Expression and protein analysis of normal skin and NMSC samples show the alteration of the expression of two enzymes involved in the serine metabolism and OCM, the Serine Hydroxy-Methyl Transferase 2 (SHMT2) and Methylen-ThetraHydroFolate dehydrogenase/cyclohydrolase 2 (MTHFD2). Tissues analysis shows that these two enzymes are mainly expressed in the proliferative areas of cBCC and in the poorly differentiated areas of cSCC, suggesting their role in tumor proliferation maintenance. Moreover, in vitro silencing of SHMT2 and MTHFD2 impairs the proliferation of epidermoid cancer cell line. Taken together these data allow us to link the central cellular metabolism (serine and/or OCM) and NMSC proliferation and progression, offering the opportunity to modulate pharmacologically the involved enzymes activity against this type of human cancer.
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Affiliation(s)
- Angela Cappello
- Department of Experimental Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167, Rome, Italy
| | | | - Mara Mancini
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167, Rome, Italy
| | - Giulia Tosetti
- Department of Experimental Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Luca Fania
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167, Rome, Italy
| | - Francesco Ricci
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167, Rome, Italy
| | - Gerry Melino
- Department of Experimental Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome "Tor Vergata", 00133, Rome, Italy.
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167, Rome, Italy.
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Brassetti A, Anceschi U, Cozzi G, Chavarriaga J, Gavrilov P, Gaya Sopena JM, Bove AM, Prata F, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Torregiani G, Covotta M, Camacho D, Musi G, Varela R, Breda A, De Cobelli O, Simone G. Combined Reporting of Surgical Quality and Cancer Control after Surgical Treatment for Penile Tumors with Inguinal Lymph Node Dissection: The Tetrafecta Achievement. Curr Oncol 2023; 30:1882-1892. [PMID: 36826107 PMCID: PMC9954864 DOI: 10.3390/curroncol30020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND To optimize results reporting after penile cancer (PC) surgery, we proposed a Tetrafecta and assessed its ability to predict overall survival (OS) probabilities. METHODS A purpose-built multicenter, multi-national database was queried for stage I-IIIB PC, requiring inguinal lymphadenectomy (ILND), from 2015 onwards. Kaplan-Meier (KM) method assessed differences in OS between patients achieving Tetrafecta or not. Univariable and multivariable regression analyses identified its predictors. RESULTS A total of 154 patients were included in the analysis. The 45 patients (29%) that achieved the Tetrafecta were younger (59 vs. 62 years; p = 0.01) and presented with fewer comorbidities (ASA score ≥ 3: 0% vs. 24%; p < 0.001). Although indicated, ILND was omitted in 8 cases (5%), while in 16, a modified template was properly used. Although median LNs yield was 17 (IQR: 11-27), 35% of the patients had <7 nodes retrieved from the groin. At Kaplan-Maier analysis, the Tetrafecta cohort displayed significantly higher OS probabilities (Log Rank = 0.01). Uni- and multivariable logistic regression analyses identified age as the only independent predictor of Tetrafecta achievement (OR: 0.97; 95%CI: 0.94-0.99; p = 0.04). CONCLUSIONS Our Tetrafecta is the first combined outcome to comprehensively report results after PC surgery. It is widely applicable, based on standardized and reproducible variables and it predicts all-cause mortality.
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Affiliation(s)
- Aldo Brassetti
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
- Correspondence: ; Tel.: +39-0652666772
| | - Umberto Anceschi
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Gabriele Cozzi
- Department of Urology, European Institute of Oncology, 20141 Milan, Italy
| | - Julian Chavarriaga
- Division of Urology, Clinica Imbanaco, Quiron Salud, Cali 760042, Colombia
- Division of Urology, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Pavel Gavrilov
- Department of Urology, Fondacio Puigvert, 08025 Barcelona, Spain
| | | | - Alfredo Maria Bove
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Francesco Prata
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | | | - Riccardo Mastroianni
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Leonardo Misuraca
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Gabriele Tuderti
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Giulia Torregiani
- Department of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Marco Covotta
- Department of Anesthesiology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
| | - Diego Camacho
- Division of Urologic Oncology Instituto Nacional de Cancerologia, Bogota 111511, Colombia
| | - Gennaro Musi
- Department of Urology, European Institute of Oncology, 20141 Milan, Italy
| | - Rodolfo Varela
- Division of Urologic Oncology Instituto Nacional de Cancerologia, Bogota 111511, Colombia
| | - Alberto Breda
- Department of Urology, Fondacio Puigvert, 08025 Barcelona, Spain
| | - Ottavio De Cobelli
- Department of Urology, European Institute of Oncology, 20141 Milan, Italy
| | - Giuseppe Simone
- Department of Urology, IRCCS “Regina Elena” National Cancer Institute, 00144 Rome, Italy
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Sali AP, Shah A, Prakash G, Murthy V, Bakshi G, Joshi A, Pal M, Aggarwal A, Desai SB, Menon S. Predictors of Pelvic Lymph Nodal Metastasis in Penile Squamous Cell Carcinoma- Results from a Matched-Pair Analysis. Clin Genitourin Cancer 2022; 21:e119-e125. [DOI: 10.1016/j.clgc.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
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Clinical Lymph Node Involvement as a Predictor for Cancer-Specific Survival in Patients with Penile Squamous Cell Cancer. Curr Oncol 2022; 29:5466-5474. [PMID: 36005170 PMCID: PMC9406784 DOI: 10.3390/curroncol29080432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to identify prognostic predictive factors of patients with penile squamous cell carcinoma (PSCC). This retrospective study reviewed the clinical and pathological data of patients with PSCC at 10 institutions in Japan between January 2008 and December 2019. The primary endpoint was cancer-specific survival (CSS). We also identified useful predictive factors for CSS in patients with PSCC. In total, 64 patients with PSCC were enrolled. At the end of the follow-up period, 15 patients (23.4%) died owing to PSCC and six (9.4%) died owing to other causes. The 2- and 3-year CSS rates were 78.9% and 76.6%, respectively. Using the Kaplan−Meier method, the Eastern Cooperative Oncology Group performance status 0, serum albumin levels ≥4.2 g/dL, hemoglobin levels ≥13.2 g/dL, C-reactive protein levels <0.21 mg/dL, clinical T stage ≤2, clinically negative lymph node (LN) status, and tumor size <30 mm were associated with a significantly better CSS. In the multivariate analysis, the clinically positive LN status was a significant predictive factor for CSS in patients with PSCC. Further prospective large-scale and long-term studies are required to validate our findings.
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Li K, Le X, Wang J, Fan C, Sun J. Tumor Location May Independently Predict Survival in Patients With M0 Squamous Cell Carcinoma of the Penis. Front Oncol 2022; 12:927088. [PMID: 35865480 PMCID: PMC9294313 DOI: 10.3389/fonc.2022.927088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo determine the association between tumor location and both clinicopathological characteristics and the survival of patients with M0 squamous cell carcinoma of the penis (SCCP).MethodsData of 455 patients diagnosed with M0 SCCP between 1975 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the United States National Cancer Institute. The effects of tumor location on overall survival (OS) and penile carcinoma-specific survival (PCSS) were analyzed using the Kaplan–Meier method. The Cox proportional hazards regression model was used to determine the impact of tumor location on PCSS.ResultsSCCP was more likely to occur in the prepuce or glans (90%). Although no significant difference was observed between the OS of patients with M0 SCCP in the prepuce or glans and those with M0 SCCP in the body of the penis (p = 0.307), the former had better PCSS (p = 0.024). Moreover, M0 SCCP in the prepuce or glans was also significantly associated with better PCSS in patients with advanced age (age ≥ 60 years, p = 0.011), other ethnicities (p = 0.003), T2–T4 stage (p = 0.036), larger tumors (≥3 cm, p = 0.001), no regional lymph nodes removed (p = 0.044), and radical surgery (p = 0.027). Multivariate analysis confirmed that tumor location is an independent prognostic factor for patients with M0 SCCP [hazard ratio (HR) 1.881, p = 0.026].ConclusionsTumor location is an independent prognostic factor for patients with M0 SCCP, and tumors in the prepuce or glans portend better PCSS.
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Affiliation(s)
| | | | | | - Caibin Fan
- *Correspondence: Caibin Fan, ; Jian Sun,
| | - Jian Sun
- *Correspondence: Caibin Fan, ; Jian Sun,
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