The Prognostic Value of Human Papillomavirus Status in Penile Cancer: Outcomes From a Norwegian Cohort Study

• Published in: Clinical genitourinary cancer 2024-10, Vol.22 (5), p.102127, Article 102127
• Main Authors: Nordanger, Ida M., Beisland, Christian, Thorkelsen, Tor Kristian, Honoré, Alfred, Juliebø-Jones, Patrick, Bostad, Leif, Berget, Ellen, Costea, Daniela E., Moen, Christian A.
• Format: Article
• Language: English
• Subjects: Cancer-specific survival; Interactions; Node-positive disease; Penile squamous cell carcinoma; Prognosis
• ISSN: 1558-7673; 1938-0682; 1938-0682
• DOI: 10.1016/j.clgc.2024.102127

•Penile cancer prognosis by TNM stages does not depend on human papillomavirus status.•Predicting metastatic nodes by T-stage does not depend on human papillomavirus status.•Predicting metastatic nodes by Grade does not depend on human papillomavirus status. Penile squamous cell carcinoma (PSCC) can develop from human papillomavirus (HPV) infection. This study investigates if the prognostic value of the TNM stage groups or the components tumor stage (pT), grade of differentiation (Grade), lymphovascular invasion (LVI), and nodular stage (pN) depend on HPV status. Also, whether the value of tumor parameters (pT, Grade, and LVI) for predicting node-positive disease depends on HPV status was investigated. Stored tumor tissue from 226 patients treated for PSCC in Western Norway between 1973 and 2023 was investigated for HPV DNA. Histopathological variables were reevaluated according to the current TNM classification. Disease course was registered from hospital records. Inclusion of an interaction term between HPV and TNM stage groups in Cox regression enabled analysis of whether cancer-specific survival (CSS) of the stage groups depended on HPV status. This was also done separately for pT, Grade, LVI, and pN. Logistic regression with interaction terms between HPV and the tumor parameters were used to investigate if their predictive value depended on HPV status. HPV DNA was detected in 43% of the tumors. Stratified by HPV status, there was no significant interaction term in the Cox regression between HPV status and TNM stage groups (P = .74). Similar results were found for pT (P = .94), Grade (P = .08), LVI (P = .91) and pN (P = .77). Moreover, there were no significant interaction terms in the logistic regression between HPV status and the tumor parameters pT, Grade, and LVI (all P > .2). This study found that prognosis of the TNM stage groups and the components pT, Grade, LVI, and pN were not modified by HPV in PSCC. The value of pT, Grade, and LVI for predicting lymph node-positive disease was not affected by HPV status. Penile cancer can develop from infection with human papillomavirus (HPV). This study investigated if the prognostic value of the TNM stage groups was different for patients with HPV-positive compared to HPV-negative tumors. We found that cancer-specific survival of the TNM stage groups did not depend on HPV status. This could be important for the follow-up of penile cancer patients.