Adjuvant radiotherapy for pN3 squamous cell carcinoma of the penis – long term survival outcomes from two UK supra-regional referral centres.
BAUS ePoster online library. Ager M. Jun 24, 2019; 259530; P4-15
Mr. Michael Ager
Mr. Michael Ager
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Supra-network policy has been to recommend adjuvant radiotherapy with concomitant low dose cisplatin delivered with radical intent for any patients with pN3 (TNM 7) SCCp of the groin or pelvis who are fit for treatment. We present the experience of two referral centres.


We audited all pN3 patients with SCCp. We included patients whose disease was deemed suitable for adjuvant therapy by the supra-network MDT. Intention to treat analysis was undertaken for those who did not start or complete adjuvant treatment. Timings were defined from last nodal surgery. Primary outcomes were disease free and cancer specific survival.


Of 151 patients, 124 completed radiotherapy +/- chemo sensitisation, 23 did not complete treatment and 4 did not start. Median age was 59 years (range 32-94).

Median follow up was 20 months.

Adjuvant (chemo)radiotherapy was started at a median 76 days (IQR 48 - 106 days). 45Gy in 20 fractions was most commonly used. Cisplatin was used in 24% (27), 47% (53) had no chemotherapy.

Of the 124 who completed adjuvant treatment, 54 relapsed at a median 5.5 months. 50% (27) were in field relapses (inguinal or pelvic).

At 5 years, DFS was 47.9% and cancer specific survival 44.3%.


Outcomes for N3 disease are better than historical series. The high infield recurrence rate may be addressed with higher doses of radiotherapy – 54Gy in 25 Fractions is now the standard. The InPACT study (NCT02305654) is testing the role of chemotherapy vs chemoradiotherapy vs upfront surgery in a randomised trial.
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