Prognosis of penile cancer associated with HPV status

Determination of human papillomavirus (HPV) status should be done routinely at diagnosis of penile cancer. HPV-positive penile cancer has a much better prognosis than HPV-negative penile cancer, independent of age, stage, comorbidities, or treatment method [1].

Dr Adithya Chennamadhavuni (University of Iowa, USA) shared the results of his team’s analysis of data from the National Cancer Database (NCDB). The analysis focussed on characteristics and outcomes of 486 men who were diagnosed with penile cancer between 2004 and 2016 and who had a known HPV status. Among 486 patients with penile squamous cell cancer, 139 (29%) had tested positive for HPV. These findings are consistent with those of previous studies, which have documented that HPV is present in 30–50% of penile cancers. The majority of participants were white, <65 years old, from low-income areas, and had either public or no insurance coverage. These characteristics were similar in HPV-negative versus HPV-positive patients.

Most HPV-positive patients presented with an early-stage tumour; at time of diagnosis, 77% had a moderately to poorly differentiated tumour. Regardless of treatment modality, a superior 5-year overall survival rate was found among HPV-positive patients: 62% versus 50% in HPV-negative patients. The risk of death in patients who had tested negative for HPV was 1.49 times that of the risk of death in patients who had tested positive for HPV. Multivariable analysis demonstrated that survival rates were superior in patients who were <65 years old, had a low Charlson-Deyo comorbidity index score (0–1), and had been diagnosed at an earlier stage of the disease.

According to Dr Chennamadhavuni, this analysis reinforces that HPV status has a bearing on the prognosis of penile cancer and should therefore be performed routinely at time of diagnosis.

1. Chennamadhavuni A. Prognostic significance of human papilloma virus (HPV) in penile cancer: A National Cancer Database (NCDB) study. Abstract 5, ASCO Genitourinary Cancers Symposium, 11–13 February 2021.

 

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Posted on 24 March 202118 June 2021