Human papillomavirus as a prognostic factor in carcinoma of the penis: analysis of 82 patients treated with amputation and bilateral lymphadenectomy.

BACKGROUND: Many studies have tried to identify prognostic factors to guide the selection of patients at high risk for metastases in penile carcinoma. The authors evaluated human papillomavirus (HPV) status with respect to clinical features, incidence of metastases, and prognosis of penile carcinoma.

METHODS: Human papillomavirus DNA was detected using the polymerase chain reaction on paraffin embedded material from 82 patients with penile carcinoma. The following variables were recorded: age, marital status, clinical staging, tumor surgery extension, histologic grade, tumor thickness, lymphatic and venous embolization, corpora cavernosa and corpus spongiosum infiltration, urethral infiltration, mononuclear and eosinophilic infiltrate, and lymph node spread. Follow-up ranged from 0.1 to 453 months.

RESULTS: Human papillomavirus DNA was detected in 30.5% (25 of 82) of samples. HPV-16 was the most frequent type detected (13 of 25, 52%). Human papillomavirus DNA positive tumors had less lymphatic embolization by neoplastic cells than HPV negative ones (P = 0.007). The logistic regression revealed that only lymphatic embolization was related to HPV status. There was no difference, however, between HPV DNA negative and HPV DNA positive patients according to presence of lymph node metastases (P = 0.386). No difference was found in the 10-year survival rate (68.4% vs. 69.1%; P = 0.830) between the two groups.

CONCLUSIONS: These data suggest that HPV status does not influence prognosis in invasive penile carcinoma.