Prognosis and survival for penile cancer

If you have penile cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage, grade and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether the cancer has spread) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for penile cancer.

Stage at diagnosis is an important prognostic factor for penile cancer. The lower the stage of penile cancer, the better the outcome. Tumours that are on the surface of the skin of the penis have a more favourable prognosis than those that have grown through the skin to the erectile tissues of the penis (corpus spongiosum or cavernosum). When diagnosed at an early stage, penile cancer can usually be cured.

Whether the cancer has spread to the lymph nodes is related to the stage of the tumour and is an important prognostic factor. Penile cancer that has not spread to lymph nodes has a better prognosis than penile cancer that has spread to lymph nodes. The number of lymph nodes and the group of lymph nodes the cancer has spread to also play a role in predicting survival. Men who have cancer in only one lymph node in the groin (inguinal lymph node) have a better chance of survival than men who have cancer in more than one inguinal lymph node or men who have cancer in a different group of lymph nodes.

Tumours that are larger than 5 cm and tumours that cover more than 75% of the shaft of the penis have an increased risk of spreading to the lymph nodes and a poorer prognosis.

Cancer that has not spread into the blood or lymph vessels (lymphovascular invasion) tends to have a better prognosis than cancer that has spread to the blood or lymph vessels.

Penile cancers that have a lower grade have a better prognosis than those with a higher grade. Tumours on the foreskin or glans (head) of the penis tend to be lower grade. Most tumours that affect the shaft of the penis tend to be higher grade. The higher the grade of the tumour, the higher the chance that the cancer has spread (metastasized) to the lymph nodes.

Some types of penile cancer have a better prognosis. Verrucous carcinoma and basal cell carcinoma are usually low grade, rarely spread to other parts of the body and have a good prognosis. Melanoma of the penis tends to grow and spread more quickly and is often at an advanced stage when diagnosed.