International case series of metastasis to penis

Penile metastases are rare, with about 400 reported via case reports or small series. Under such circumstances coherent data about their behaviour may not be possible given vagaries of publication. For instance, one published meta-analysis has proposed that malignant priapism contributes to worse survival, but this may be due to selection bias in published reports. We sought to evaluate clinical characteristics associated with survival in an international cohort of patients with metastases to the penis treated in major genitourinary cancer programmes. ObjectivesResultsTo evaluate clinical characteristics associated with survival in patients with metastases to the penis.MethodsAfter approval by the IRB, records of collaborating centres in Leuven, London, Rostock, Amsterdam and Tampa were screened for men presenting with metastatic disease to penis. Multivariate logistic regression analyses were used to identify covariables associated with survival. We analysed clinical data on 34 patients.Primary sites were most frequently prostate (n = 14, 41%) and bladder (n = 9, 26%). Twenty-eight of 34 (82%) presented with metachronous penile metastases, and 11 (32%) patients had penile metastases as the sole metastatic site. Penile metastatic locations were most frequently in the corpora (n = 18; 53%). Seven (21%) patients with penile metastases had priapism on presentation. Systemic therapy was frequent and variable (chemotherapy n = 12; immunotherapy n = 5; hormones n = 3). Local management included either surgery (n = 10) or RT (n = 8). Twelve- and 24-month overall survival rate were 67% and 35%, respectively. No clinical parameter including primary histology, synchronous or metachronous metastases or priapism showed statistical survival benefit or detriment.ConclusionMetastasis to penis arises most frequently from pelvic primaries. Priapism does not appear to correlate with survival in this large, well-defined series.