Kattan et al developed a nomogram for predicting 5 year tumor specific survival in a male undergoing partial or total amputation of the penis for squamous cell carcinoma based solely on pathologic findings. This can help identify a patient who may benefit from more aggressive management. The authors are from the Cleveland Clinic and multiple hospitals in Italy (GUONE Penile Cancer Project).
Parameters:
(1) tumor thickness in millimeters
(2) growth pattern
(3) histologic grade
(4) lymphovascular emboli
(5) invasion of corpora cavernosa
(6) invasion of corpora spongiosum
(7) invasion of the urethra
(8) clinical lymph node status
|
Parameter |
Finding |
Points |
|
tumor thickness |
<= 5 mm |
0 |
|
|
> 5 mm |
32 |
|
growth pattern |
vertical |
0 |
|
|
superficial |
16 |
|
histologic grade |
Grade 1 (well-differentiated) |
0 |
|
|
Grade 2 |
14 |
|
|
Grade 3 (poorly differentiated) |
35 |
|
embolization group |
absent |
0 |
|
|
present |
43 |
|
invasion of corpora cavernosa |
absent |
0 |
|
|
present |
25 |
|
invasion of corpora spongiosum |
absent |
0 |
|
|
present |
19 |
|
invasion of urethra |
absent |
0 |
|
|
present |
7.5 |
|
pathologic lymph node status |
negative (pN0) |
0 |
|
|
positive (pN+) |
93 |
|
|
unknown (pNx) |
100 |
where:
• Assigning more points to pNx than pN+ seems a bit odd.
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 288 by table above (scale in figure goes to 300)
• The higher the score the worse the 5 year survival.
|
Total Score |
Probability of 5 Year Tumor Specific Survival |
|
< 3.5 |
> 98% |
|
3.5 to 104 |
(-0.000011 * ((points)^2) + (0.000055 * (points)) + 0.9792 |
|
104 to 206 |
(-0.000028 * ((points)^2) + (0.003252 * (points)) + 0.8306 |
|
206 to 272 |
(0.000056 * ((points)^2)) - (0.03114 * (points)) + 4.341 |
|
> 272 |
< 1% |
Specialty: Hematology Oncology, Surgery, general, Urology
ICD-10: ,
