Prediction of distant metastases in penile squamous cell carcinoma: a SEER population-based study

Due to the limited number of patients with penile cancer, there is currently no prospective randomized study on patients with penile cancer, especially on patients with distant metastasis of penile cancer. The objective of this study was to develop a nomogram based on a large cohort to predict the probability of distant metastasis in patients with penile squamous cell carcinoma. 1453 patients were included in our study. Univariate and multivariate logistic regression analyses were employed to identify the independent variables, which were used to construct a nomogram. In this nomogram, high grade, high N stage, and primary site surgery (OR 0.354, 95% CI 0.146-0.859) were predictors of distant metastasis in patients with penile squamous cell carcinoma. The area under the curve (AUC) for internal validation of this nomogram was 0.880. Incisional biopsy of regional lymph nodes had been demonstrated to be associated with a poorer survival prognosis in patients with one distant metastatic site. Furthermore, patients with two metastases had a significantly worse survival rate than those with a single metastasis. These findings may prove instrumental in the surgical decision-making process.