Skip to main content
SpringerLink
Log in

Development and validation of HPV-associated and HPV-independent penile squamous cell carcinoma prognostic nomogram

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to introduce HPV-associated and HPV-independent histologic classifications to analyze prognostic factors and develop a prognostic nomogram for patients with penile squamous cell carcinoma (PSCC).

Methods

Data of 1502 PSCC patients between 2010 and 2020 were accessed from the SEER database, and the patients were randomly divided into a training set and a validation set. Independent risk factors for PSCC patients prognosis were analyzed by using univariate and multivariate COX proportional hazards regression, and was used for the construction of the nomogram, and the predictive performance of the model was evaluated by C-index, calibration curve and ROC curve. Kaplan–Meier analysis was applied to explore the impact of HPV-related factors on patient survival, while propensity score matching (PSM) and inverse probability treatment weighting (IPTW) techniques were used to balance other confounding factors like individual clinical and pathological factors, and to evaluate the differences in overall survival (OS) and cause-specific survival (CSS) between subgroups.

Result

The results indicated that histologic type, Grade classification, T/M stage, surgical methods and chemotherapy were independent risk factors affecting OS and CSS in PSCC patients. In addition, age and marital status were significantly associated with OS, while lymph node metastasis was an independent prognostic factor for CSS, the validation results of the model showed that the nomogram had a superior predictive performance compared with the American Joint Committee on Cancer staging system. In addition, subgroup analyses prior to and after IPTW and PSM adjustments showed that HPV-associated group had better OS and CSS than HPV-independent group.

Conclusion

Our study developed and validated a nomogram using a novel histologic classification and achieved satisfactory results, which can better help clinicians to predict the prognosis of penile squamous cell carcinoma patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Data availability

The data analyzed during the current study are available in the SEER database repository, [https://seer.cancer.gov/data/].

References

  1. Mentrikoski MJ, Stelow EB, Culp S, Frierson HF Jr, Cathro HP (2014) Histologic and immunohistochemical assessment of penile carcinomas in a North American population. Am J Surg Pathol 38(10):1340–1348. https://doi.org/10.1097/PAS.0000000000000124

    Article  PubMed  Google Scholar 

  2. Wenzel M, Siron N, Collà Ruvolo C, et al (2022) Temporal trends, tumor characteristics and stage-specific survival in penile non-squamous cell carcinoma vs. squamous cell carcinoma. Cancer Causes Control 33(1):25–35. https://doi.org/10.1007/s10552-021-01493-3

  3. Alemany L, Cubilla A, Halec G et al (2016) Role of human papillomavirus in penile carcinomas worldwide. Eur Urol 69(5):953–961. https://doi.org/10.1016/j.eururo.2015.12.007

    Article  PubMed  Google Scholar 

  4. Elst L, Albersen M (2022) Hpv vaccination: does it have a role in preventing penile cancer and other preneoplastic lesions? Semin Oncol Nurs 38(3):151284. https://doi.org/10.1016/j.soncn.2022.151284

    Article  PubMed  Google Scholar 

  5. Olesen TB, Sand FL, Rasmussen CL et al (2019) Prevalence of human papillomavirus DNA and p16INK4a in penile cancer and penile intraepithelial neoplasia: a systematic review and meta-analysis. Lancet Oncol 20(1):145–158. https://doi.org/10.1016/S1470-2045(18)30682-X

    Article  CAS  PubMed  Google Scholar 

  6. Menon S, Moch H, Berney DM et al (2023) WHO 2022 classification of penile and scrotal cancers: updates and evolution. Histopathology 82(4):508–520. https://doi.org/10.1111/his.14824

    Article  CAS  PubMed  Google Scholar 

  7. Li R, Cheng K, Wei Z, Liu Z, Peng X (2022) The development and validation of a nomogram incorporating clinical, pathological, and therapeutic features to predict overall survival in patients with penile cancer: a SEER-based study. Front Oncol 12:840367. Published 2022 Apr 5. https://doi.org/10.3389/fonc.2022.840367

  8. Mao W, Zhang Z, Huang X, Fan J, Geng J (2019) Marital status and survival in patients with penile cancer. J Cancer 10(12):2661–2669. Published 2019 Jun 2. https://doi.org/10.7150/jca.32037

  9. Ficarra V, Zattoni F, Cunico SC et al (2005) Lymphatic and vascular embolizations are independent predictive variables of inguinal lymph node involvement in patients with squamous cell carcinoma of the penis: Gruppo Uro-Oncologico del Nord Est (Northeast Uro-Oncological Group) Penile Cancer data base data. Cancer 103(12):2507–2516. https://doi.org/10.1002/cncr.21076

    Article  PubMed  Google Scholar 

  10. Clark PE, Spiess PE, Agarwal N et al (2013) Penile cancer: clinical practice guidelines in oncology. J Natl Compr Canc Netw 11(5):594–615. https://doi.org/10.6004/jnccn.2013.0075

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Lont AP, Kroon BK, Horenblas S et al (2006) Presence of high-risk human papillomavirus DNA in penile carcinoma predicts favorable outcome in survival. Int J Cancer 119(5):1078–1081. https://doi.org/10.1002/ijc.21961

    Article  CAS  PubMed  Google Scholar 

  12. Sand FL, Rasmussen CL, Frederiksen MH, Andersen KK, Kjaer SK (2018) Prognostic significance of HPV and p16 status in men diagnosed with penile cancer: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 27(10):1123–1132

    Article  CAS  PubMed  Google Scholar 

  13. Cole SR, Hernán MA (2008) Constructing inverse probability weights for marginal structural models. Am J Epidemiol 168(6):656–664. https://doi.org/10.1093/aje/kwn164

    Article  PubMed  PubMed Central  Google Scholar 

  14. Austin PC, Stuart EA (2015) Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies. Stat Med 34(28):3661–3679. https://doi.org/10.1002/sim.6607

    Article  PubMed  PubMed Central  Google Scholar 

  15. Thomas A, Necchi A, Muneer A, et al (2021) Penile cancer. Nat Rev Dis Primers 7(1):11. Published 2021 Feb 11. https://doi.org/10.1038/s41572-021-00246-5

  16. Harder T, Wichmann O, Klug SJ, van der Sande MAB, Wiese-Posselt M (2018) Efficacy, effectiveness and safety of vaccination against human papillomavirus in males: a systematic review. BMC Med 16(1):110. Published 2018 Jul 18. https://doi.org/10.1186/s12916-018-1098-3

  17. Lohneis P, Boral S, Kaufmann AM et al (2015) Human papilloma virus status of penile squamous cell carcinoma is associated with differences in tumour-infiltrating T lymphocytes. Virchows Arch 466(3):323–331. https://doi.org/10.1007/s00428-014-1713-4

    Article  PubMed  Google Scholar 

  18. Dräger DL, Milerski S, Sievert KD, Hakenberg OW (2018) Psychosoziale Auswirkungen bei Patienten mit Peniskarzinom: Ein systematischer Überblick [Psychosocial effects in patients with penile cancer: a systematic review]. Urologe A 57(4):444–452. German. https://doi.org/10.1007/s00120-018-0603-9

Download references

Funding

No funding, grants or other support was received during the writing of this manuscript.

Author information

Authors and Affiliations

  1. Bengbu Medical University, No. 2600 Donghai Road, Bengbu, 233000, Anhui, China

    Song Liu, Haoran Yang, Zhipeng Lu & Tao Huang

  2. Department of Urology Surgery, The First Affiliated Hospital of USTC, Hefei, Anhui, China

    Zhou Shen, Jing Wang & Shuhan Liu

  3. Wannan Medical College, Wuhu, Anhui, China

    Xing Wang & Yiming Gong

Authors
  1. Song Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhou Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haoran Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yiming Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shuhan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Zhipeng Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tao Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SL: project design and development, manuscript writing and editing. TH: project design and development, manuscript editing. ZS: data analysis, manuscript polishing and editing. JW: data analysis. HY: data analysis. XW: data collection. YG: data analysis. ZL: data analysis. SL: project development.

Corresponding author

Correspondence to Tao Huang.

Ethics declarations

Ethics approval

Data from the SEER database were obtained in a public manner, no ethical approval is required.

Conflict of interest

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 22 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, S., Shen, Z., Yang, H. et al. Development and validation of HPV-associated and HPV-independent penile squamous cell carcinoma prognostic nomogram. Int Urol Nephrol (2024). https://doi.org/10.1007/s11255-024-04043-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11255-024-04043-3

Keywords

Search

Navigation