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Yang S, Chang W, Zhang B, Hou Q, Zhang B, Kang Y, Yin Y, Wan J, Shang P. Development and validation of a predictive model for penile cancer based on the surveillance, epidemiology, and end results database and multi-center cases. J Cancer Res Clin Oncol 2023; 149:13665-13676. [PMID: 37522926 DOI: 10.1007/s00432-023-04784-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/15/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE Penile cancer (PC) is a great impact on the quality of life and psychological status of patients. This study aimed to construct nomograms using data from the Surveillance, Epidemiology, and End Results (SEER) database to predict overall survival (OS) and cancer-specific survival (CSS) in patients with penile cancer (PC). METHODS Patients were divided into a training cohort (n = 634) and a validation cohort (n = 272) in a 7:3 ratio. Independent risk factors influencing the prognosis of PC were screened using univariate and multivariate Cox analyses, and models for predicting PC were developed. Data from 203 patients with PC in four tertiary hospitals in Gansu Province from 2012 to 2021 were externally validated. RESULTS Univariate analysis and multivariate analysis showed revealed that the OS-related factors were age, grade, T stage, N stage, M stage and tumor size (p < 0.05); the CSS-related factors were age, mode of surgery, T stage, N stage, M stage and tumor size (p < 0.05). The C-indices of the OS and CSS nomograms in the training cohort were 0.743 [95% confidence interval (CI) (0.714-0.772)] and 0.797 (0.762-0.832), respectively. The C-indices of the OS and CSS nomograms in the internal validation cohort were 0.735 (0.686-0.784) and 0.755 (0.688-0.822), respectively, and those in the external validation cohort were 0.801 (0.746-0.856) and 0.863 (0.812-0.914), respectively. Receiver operating characteristic (ROC) curves, calibration curves, and survival curves all demonstrated good predictive performance of the nomograms. CONCLUSION The nomograms for PC were developed using the SEER database. The accuracy and clinical usefulness of the model were validated through a combination of internal and external validations.
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Affiliation(s)
- Shujun Yang
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Wei Chang
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Bin Zhang
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Qian Hou
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Biao Zhang
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China
| | - Yindong Kang
- Department of Urology, The 940th Hospital of Joint Logistics Support Force of People's Liberation Army, Lanzhou, Gansu, China
| | - Yongsheng Yin
- Department of Urology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
| | - Jianghou Wan
- Department of Urology, First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Panfeng Shang
- Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
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Yamaguchi T, Goya M, Higashijima K, Tobu S, Sato R, Tatarano S, Mukai S, Uemura KI, Tatsugami K, Tsubouchi K, Shida Y, Ishii T, Sakai H, Matsuoka H, Haga N, Eto M, Igawa T, Kamoto T, Enokida H, Shin T, Noguchi M, Fujimoto N, Saito S, Kamba T. Real-world treatment outcomes of patients with penile cancer in the Kyushu-Okinawa area of Japan in the pre-guideline era. Jpn J Clin Oncol 2023; 53:837-844. [PMID: 37282601 DOI: 10.1093/jjco/hyad053] [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: 03/29/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVES To understand the real-world outcomes for patients with penile cancer in the Kyushu-Okinawa area before the introduction of practice guidelines in Japan. METHODS We retrospectively collected medical information on patients with penile squamous cell carcinoma and penile intraepithelial neoplasia at 12 university hospitals and their affiliated hospitals in the Kyushu-Okinawa area from January 2009 to December 2020. Patients with unknown clinical stage were excluded. Patient background characteristics and survival, as well as pretreatment factors involved in survival, were investigated. RESULTS A total of 196 patients were included. Patients with clinical stage 0, I, IIA, IIB, IIIA, IIIB and IV comprised 9.7, 26.0, 22.4, 2.6, 10.7, 14.3 and 14.3%, respectively. The median follow-up was 26 months, and the mean 5-year overall survival and cancer-specific survival rates were 74.3 and 79.8%, respectively. On univariate analysis, tumor diameter ≥ 30 mm, penile shaft tumor, Eastern Cooperative Oncology Group performance status ≥ 1, cT ≥ 3, cN ≥ 2 and cM1 were associated with significantly poorer cancer-specific survival. On multivariate analysis, pretreatment factors of cN ≥ 2 (hazard ratio, 32.5; 95% confidence interval, 5.08-208; P = 0.0002), Eastern Cooperative Oncology Group performance status ≥ 1 (4.42; 1.79-10.9; P = 0.0012) and cT ≥ 3 (3.34; 1.11-10.1; P = 0.0319) were identified as independent prognostic factors. CONCLUSIONS The study revealed basic data for future penile cancer treatment and research, including survival rates according to clinical stages, and identified cN ≥ 2, Eastern Cooperative Oncology Group performance status ≥ 1 and cT ≥ 3 at initial diagnosis as independent prognostic factors. Evidence for penile cancer in Japan is particularly scarce, and future large-scale prospective studies are warranted.
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Affiliation(s)
- Takahiro Yamaguchi
- Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
| | - Masato Goya
- Department of Urology, Chubu Tokushukai Hospital, Kitanakagusuku, Okinawa, Japan
| | - Katsuyoshi Higashijima
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Shohei Tobu
- Department of Urology, Faculty of Medicine, Saga University, Saga, Saga, Japan
| | - Ryuta Sato
- Department of Urology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Shuichi Tatarano
- Department of Urology, Faculty of Medicine, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Shoichiro Mukai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Kei-Ichiro Uemura
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Katsunori Tatsugami
- Department of Urology, Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan
| | - Kazuna Tsubouchi
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan
| | - Yohei Shida
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Tatsu Ishii
- Department of Urology, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan
| | - Hideki Sakai
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Hirofumi Matsuoka
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan
| | - Nobuhiro Haga
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Tsukasa Igawa
- Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Toshiyuki Kamoto
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
| | - Hideki Enokida
- Department of Urology, Faculty of Medicine, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Toshitaka Shin
- Department of Urology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Mitsuru Noguchi
- Department of Urology, Faculty of Medicine, Saga University, Saga, Saga, Japan
| | - Naohiro Fujimoto
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan
| | - Tomomi Kamba
- Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan
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Development and Verification of Prognostic Nomogram for Penile Cancer Based on the SEER Database. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8752388. [PMID: 35419456 PMCID: PMC9001101 DOI: 10.1155/2022/8752388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022]
Abstract
Aim We aimed to establish a prognostic nomogram for penile cancer (PC) patients based on the Surveillance, Epidemiology, and End Results Program (SEER) database. Methods Data from 1643 patients between 2010 and 2015 were downloaded and extracted from the SEER database. They were randomly divided into the development group (70%) and the verification group (30%), and then, univariate and multivariate Cox proportional hazards regression, respectively, was used to explore the possible risk factors of PC. The factors significantly related to overall survival (OS) and cancer-specific survival (CSS) were used to establish the nomogram, which was assessed via the concordance index (C-index), receiver operating characteristic (ROC) curve, and calibration curve. An internal validation was conducted to test the accuracy and effectiveness of the nomogram. Kaplan–Meier calculation was used to predict the further OS and CSS status of these patients. Results On multivariate Cox proportional hazards regression, the independent prognostic risk factors associated with OS were age, race, marital status, N/M stage, surgery, surgery of lymph nodes, and histologic type, with a moderate C-index of 0.737 (95% confidence interval (CI): 0.713–0.760) and 0.766 (95% CI: 0.731–0.801) in the development and verification groups, respectively. The areas under the ROC (AUC) of 3- and 5-year OS were 0.749 and 0.770, respectively. While marital status, N/M stage, surgery, surgery of lymph nodes, and histologic type were significantly linked to PC patients' CSS, which have better C-index of 0.802 (95% confidence interval (CI): 0.771–0.833) and 0.82 (95% CI: 0.775–0.865) in the development and verification groups, and the AUC of 3- and 5-year CSS were 0.766 and 0.787. Both of the survival calibration curves of 3- and 5-year OS and CSS brought out a high consistency. Conclusion Our study produced a satisfactory nomogram revealing the survival of PC patients, which could be helpful for clinicians to assess the situation of PC patients and to implement further treatment.
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