Determination of human papillomavirus (HPV) status should be done routinely at diagnosis of penile cancer. HPV-positive penile cancer has a much better prognosis, independent of age, stage, comorbidities, or treatment method . Dr. Chennamadhavuni (University of Iowa, USA) shared the results of his team’s analysis of data from the National Cancer Database (NCDB), which looked at the characteristics and outcomes of 486 men who were diagnosed with penile cancer between 2004 and 2016 and who had known HPV status. Among 486 patients with penile squamous cell cancer, 139 (29%) had tested positive for HPV. The remaining 347 cases (71%) were negative 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 patients were white, <65 years old, and from low-income areas. These characteristics were true in both HPV-negative and HPV-positive patients. The majority of HPV-positive patients presented with an early-stage tumor; at time of diagnosis, 77% of them had a moderately to poorly differentiated tumor. Regardless of treatment modality, analysis revealed a superior 5-year overall survival rate among HPV-positive patients of 62% versus only 50% in those who were HPV-negative. 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 comorbidity score (0-1), and had been diagnosed at an earlier stage of the disease. Chennamadhavuni’s team asserted that their analysis reinforces that HPV status has a bearing on the prognosis of penile cancer and should therefore be performed routinely at time of diagnosis.
- Chennamadhavuni A. Prognostic significance of human papillomavirus (HPV) in penile cancer: A National Cancer Database (NCDB) study. ASCO Genitourinary Cancers Symposium, 11-13 February 2021.