Background:Penile cancer is an uncommon malignancy in European and North America countries, accounting for less than 1% of malignant neoplasms. The etiology of penile cancer involves a complex interplay of clinical and behavioral factors, including phimosis, smoking, excess body weight, and HPV infection. The significance of these factors varies according to geographical and socioeconomic contexts. A comprehensive understanding of these interactions is essential for developing targeted prevention strategies and improving outcomes across diverse populations. However, the majority of existing studies originate from South America or Africa; there is a lack of data regarding these associations and prognoses in European populations, particularly in Central Europe, including Poland.Objectives: This study aimed to investigate the prevalence of well-established clinical and behavioral characteristics associated with penile cancer and their influence on penile cancer prognosis in a cohort of 153 patients who underwent surgical intervention at a single tertiary medical center in Central Europe.Materials and Methods: This retrospective study was conducted from October 2011 to October 2024 at a single tertiary medical center and included 153 patients who underwent surgical treatment for penile cancer during this period. Demographic and histopathological data were collected. A comprehensive, self-administered patient survey was conducted to identify the presence of potentially relevant clinical and lifestyle characteristics. Moreover, the prevalence of human papillomavirus (HPV) in penile cancer specimens was determined using p16 immunohistochemistry.Results: The median age of the participants in the study was 64 years (range: 30–87). The predominant identified features were phimosis (47.06%), residence in small agglomerations (43.14%), obesity (43.14%), overweight (40.52%), and smoking (38.56%). HPV infection was detected in only 14.38% of the patients. Phimosis was associated with a more locally advanced penile cancer stage (T-stage). The stage of the primary tumor, lymph node involvement, and histopathological grading significantly affected patient survival, with a poorer prognosis observed in more advanced stages and associated with poorly differentiated histopathological features. Among all the examined clinical and lifestyle characteristics, only smoking demonstrated a significant two-fold higher risk of mortality and was associated with a significantly lower overall survival compared to the absence of smoking (p= 0.047). Conversely, human papillomavirus (HPV) infection was associated with a six-fold reduction in the risk of death (p= 0.063).Conclusions: Phimosis was the most frequently observed clinical characteristic in our cohort study and was correlated with a more advanced penile cancer tumor stage. Smoking was associated with lower rates of patient survival, while HPV-positive patients demonstrated a trend toward lower mortality compared to HPV-negative patients.
背景：阴茎癌在欧洲及北美国家属罕见恶性肿瘤，占所有恶性新生物比例不足1%。其病因涉及临床与行为因素间的复杂相互作用，包括包茎、吸烟、体重超标及HPV感染。这些因素的重要性因地域和社会经济背景而异。全面理解这些相互作用对于制定针对性预防策略及改善不同人群预后至关重要。然而现有研究多源自南美或非洲地区，关于欧洲人群特别是包括波兰在内的中欧地区患者中这些关联因素与预后的数据仍显匮乏。 目的：本研究旨在探讨153例于中欧某三级医疗中心接受手术治疗的阴茎癌患者队列中，已明确的临床与行为特征的流行情况及其对阴茎癌预后的影响。 材料与方法：这项回顾性研究于2011年10月至2024年10月在某三级医疗中心开展，纳入期间接受阴茎癌手术治疗的153例患者。收集人口学与组织病理学数据，并通过综合性患者自填问卷识别潜在相关的临床与生活方式特征。此外，采用p16免疫组化法检测阴茎癌标本中人乳头瘤病毒（HPV）的流行情况。 结果：研究参与者中位年龄为64岁（范围：30-87岁）。主要特征包括包茎（47.06%）、小型聚居区居住（43.14%）、肥胖（43.14%）、超重（40.52%）及吸烟（38.56%）。仅14.38%患者检测到HPV感染。包茎与更晚期的阴茎癌局部进展阶段（T分期）相关。原发肿瘤分期、淋巴结受累及组织病理学分级显著影响患者生存，更晚期分期及低分化组织病理学特征与较差预后相关。在所有考察的临床与生活方式特征中，仅吸烟显示死亡风险显著增加两倍，且与不吸烟者相比总生存率显著降低（p=0.047）。相反，人乳头瘤病毒（HPV）感染与死亡风险降低六倍相关（p=0.063）。 结论：在本队列研究中，包茎是最常见的临床特征，且与更晚期的阴茎癌肿瘤分期相关。吸烟与患者生存率降低相关，而HPV阳性患者与HPV阴性患者相比呈现死亡率降低的趋势。
肿瘤(癌症)患者之家