Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria.
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Cancer Epidemiol. 2023 Oct;86:102424. doi: 10.1016/j.canep.2023.102424. Epub 2023 Jul 26.
We tested for regional-specific differences in patient, tumor and treatment characteristics as well as cancer-specific mortality (CSM) of squamous cell carcinoma of the penis (SCCP) patients, across the Surveillance, Epidemiology, and End Results (SEER) registries.
The SEER database (2000-2018) was used to tabulate patient (age at diagnosis, race/ethnicity), tumor (stage, grade, N-stage) and treatment characteristics (proportions of primary tumor surgery, local lymph node surgery, systemic therapy), according to 12 SEER registries. Multinomial regression models, as well as multivariable Cox regression models tested for CSM differences, adjusting for patient, tumor and treatment characteristics.
In 5395 SCCP patients, registry-specific patient counts ranged from 2060 (38 %) to 64 (1 %). Differences across registries existed for race/ethnicity, stage, grade and N-stage. Additionally, in stage I-II SCCP patients, proportions of local tumor destruction (LTD) ranged from 19 % to 39 % and from 33 % to 61 % for partial penectomy. In stage III-IV SCCP patients, proportions of partial penectomy ranged from 40 % to 59 % and from 17 % to 50 % for radical penectomy. Local lymph node surgery ranged from 8 % to 24 % and proportions of systemic therapy ranged from 3 % to 14 %. Significant inter-registry differences remained, after adjustment for treatment proportions. Unadjusted five-year CSM ranged from 19 % to 32 %. In multivariable analyses, one registry exhibited significantly higher CSM (SEER registry 10, Hazard Ratio [HR] 1.48), relative to the largest reference registry (SEER registry 1, n = 2060).
Important regional differences including patient, tumor and treatment characteristics exist for SCCP patients across SEER registries. After multivariable adjustment, no differences in CSM were recorded, with the exception of one registry.
我们在监测、流行病学和最终结果（SEER）登记处测试了患者、肿瘤和治疗特征以及阴茎鳞状细胞癌（SCCP）患者的癌症特异性死亡率（CSM）的区域特异性差异。
使用 SEER 数据库（2000-2018 年）根据 12 个 SEER 登记处，列出患者（诊断时的年龄、种族/族裔）、肿瘤（分期、分级、N 分期）和治疗特征（原发肿瘤手术、局部淋巴结手术、全身治疗的比例）。多变量回归模型和多变量 Cox 回归模型测试了 CSM 差异，调整了患者、肿瘤和治疗特征。
在 5395 名 SCCP 患者中，各登记处的患者人数从 2060（38%）到 64（1%）不等。各登记处之间存在种族/族裔、分期、分级和 N 分期的差异。此外，在 I-II 期 SCCP 患者中，局部肿瘤破坏（LTD）的比例从 19%到 39%不等，部分阴茎切除术的比例从 33%到 61%不等。在 III-IV 期 SCCP 患者中，部分阴茎切除术的比例从 40%到 59%不等，根治性阴茎切除术的比例从 17%到 50%不等。局部淋巴结手术的比例从 8%到 24%不等，全身治疗的比例从 3%到 14%不等。调整治疗比例后，仍存在显著的登记处间差异。未调整的五年 CSM 从 19%到 32%不等。在多变量分析中，一个登记处的 CSM 明显较高（SEER 登记处 10，风险比[HR]1.48），与最大的参考登记处（SEER 登记处 1，n=2060）相比。
在 SEER 登记处中，SCCP 患者存在重要的区域差异，包括患者、肿瘤和治疗特征。经过多变量调整，除了一个登记处外，没有记录到 CSM 的差异。
