{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T14:17:17Z","timestamp":1784297837918,"version":"3.55.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Little research has investigated the prevalence and distribution of the diverse pathologies of non-squamous cell carcinoma (non-SCC) of the penis. Although rare in clinical practice, these cancers have become a focus of greater importance among patients, clinicians, and researchers, particularly in developing countries. The principal objective of this study was to analyze the major types of penile non-SCC, elucidate common treatment pathways, and highlight outcomes including 5-year survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials\/methods<\/jats:title><jats:p>The Surveillance, Epidemiology, and End Results (SEER) database was queried between 2000 and 2018 to identify a retrospective cohort of patients with penile non-SCC. Demographic information, cancer characteristics, diagnostic methods, treatments administered, and survival were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 547 cases of penile non-SCC were included in the analysis. The most prevalent non-SCC cancers included epithelial neoplasms, not otherwise specified (NOS) (15.4%), unspecified neoplasms (15.2%), basal cell neoplasms (13.9%), blood vessel tumors (13.0%), nevi and melanomas (11.7%), and ductal and lobular neoplasms (9.9%). Over half (56.7%) of patients elected to undergo surgical intervention. Patients rarely received systemic therapy (3.8%) or radiation (4.0%). Five-year survival was 35.5%. Patients who underwent surgery had greater annual survival for 0\u201310 years compared to those who did not have surgery. Significant differences in survival were found between patients who had regional, localized, and distant metastases (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). A significant difference in survival was found for patients married at diagnosis versus those who were unmarried at diagnosis (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). Lower survival rates were observed for patients older than 70 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Although less prevalent than SCC, penile non-SCC encompasses a diverse set of neoplasms. Patients in this cohort had a high utilization of surgical management leading to superior outcomes compared to those not receiving surgery. Radiation is an uncommonly pursued treatment pathway. Patient demographics and socioeconomic variables such as marital status may be valuable when investigating cancer outcomes. This updated database analysis can help inform diagnosis, management, and clinical outcomes for this rare group of malignancies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1271913","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T11:33:21Z","timestamp":1698752001000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["A SEER database retrospective cohort of 547 patients with penile non-squamous cell carcinoma: demographics, clinical characteristics, and outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Lucas W.","family":"Ashley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent F.","family":"Sutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Ju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melisa","family":"Pasli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Bhatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3322\/caac.21763","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J Clin"},{"key":"B2","volume-title":"Penile cancer","author":"Engelsgjerd","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2196\/34874","article-title":"Global pattern and trends in penile cancer incidence: population-based study","volume":"8","author":"Fu","year":"2022","journal-title":"JMIR Public Health Surveill"},{"key":"B4","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2012.10.029","article-title":"Population-based survival of penile cancer patients in Europe and the United States of America: no improvement since 1990","volume":"49","author":"Verhoeven","year":"2013","journal-title":"Eur J Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2017.08.014","article-title":"FRANCIM network; Grosclaude P. Long-term trends in incidence and survival of penile cancer in France","volume":"50","author":"Daubisse-Marliac","year":"2017","journal-title":"Cancer Epidemiol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00120-018-0603-9","article-title":"Psychosoziale Auswirkungen bei Patienten mit Peniskarzinom: Ein systematischer \u00dcberblick [Psychosocial effects in patients with penile cancer: A systematic review]","volume":"57","author":"Dr\u00e4ger","year":"2018","journal-title":"Urologe A."},{"key":"B8","first-page":"7","article-title":"Penile cancer in India: a clinicoepidemiological study","author":"Pahwa","year":"2012","journal-title":"Gulf J Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/iju.IJU_221_19","article-title":"Management of clinically node-negative groin in patients with penile cancer","volume":"36","author":"Niyogi","year":"2020","journal-title":"Indian J Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1002\/jmv.20703","article-title":"The prevalence of human papillomavirus genotypes in penile cancers from northern Thailand","volume":"78","author":"Senba","year":"2006","journal-title":"J Med Virol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2017.05.19","article-title":"Updates on the epidemiology and risk factors for penile cancer","volume":"6","author":"Douglawi","year":"2017","journal-title":"Transl Androl Urol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/dsu.12029","article-title":"Malignant tumors of the penis","volume":"39","author":"Brady","year":"2013","journal-title":"Dermatol Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.eururo.2016.02.029","article-title":"The 2016 WHO classification of tumours of the urinary system and male genital organs-part A: renal, penile, and testicular tumours","volume":"70","author":"Moch","year":"2016","journal-title":"Eur Urol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2020.11.025","article-title":"A population-level analysis of nonsquamous penile cancer: the importance of histology","author":"Bhambhvani","year":"2020","journal-title":"Urol Oncol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s10552-021-01493-3","article-title":"Temporal trends, tumor characteristics and stage-specific survival in penile non-squamous cell carcinoma vs. squamous cell carcinoma","volume":"33","author":"Wenzel","year":"2022","journal-title":"Cancer Causes Control"},{"key":"B16","article-title":"Secondary NK\/T cell lymphoma after radiotherapy for non-HPV-related squamous cell carcinoma of the penis: an early warning event and literature review","volume":"13","author":"Sun","year":"2020","journal-title":"Int J Clin Exp Pathol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2016\/20315.8178","article-title":"Penile sarcoma: report of a rare Malignancy","volume":"10","author":"Rajan","year":"2016","journal-title":"J Clin Diagn Res"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.17809","article-title":"Extramedullary waldenstr\u00f6m macroglobulinemia presenting as a subcutaneous penile mass","volume":"13","author":"Palmer","year":"2021","journal-title":"Cureus"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.21037\/tau-21-277","article-title":"Primary epithelioid hemangioendothelioma of the penis: a case report and literature review","volume":"10","author":"Artiles Medina","year":"2021","journal-title":"Transl Androl Urol"},{"key":"B20","unstructured":"Overview of the SEER program2023"},{"key":"B21","unstructured":"Male genital system - surveillance, epidemiology, and end results program"},{"key":"B22","unstructured":"Treatment by cancer type. NCCN"},{"key":"B23","doi-asserted-by":"publisher","first-page":"731","DOI":"10.3332\/ecancer.2017.731","article-title":"Penile melanoma: a 20-year analysis of six patients at the National cancer institute of Peru, Lima","volume":"11","author":"Jabiles","year":"2017","journal-title":"Ecancermedicalscience"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-013-1216-y","article-title":"Non-squamous cell carcinoma of the penis: single-center, 15-year experience","volume":"32","author":"Moses","year":"2014","journal-title":"World J Urol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.11.009","article-title":"Primary genitourinary melanoma: epide- miology and disease-specific survival in a large population-based cohort","volume":"34","author":"Sanchez","year":"2016","journal-title":"Urol Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1590\/S1677-5538.IBJU.2013.06.08","article-title":"Penile primary melanoma: analysis of six patients treated at Brazilian national cancer institute in the last eight years","volume":"39","author":"Bechara","year":"2013","journal-title":"Int Braz J Urol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000159207.91737.53","article-title":"Melanoma of the penis, scrotum and male urethra: a 40-year single institution experience","volume":"173","author":"S\u00e1nchez-Ortiz","year":"2005","journal-title":"J Urol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.ejca.2018.12.036","article-title":"Diagnosis and treatment of Kaposi\u2019s sarcoma: European consensus-based interdisciplinary guideline (EDF\/EADO\/EORTC)","volume":"114","author":"Lebbe","year":"2019","journal-title":"Eur J Cancer"},{"key":"B29","unstructured":"Kaposi Sarcoma Treatment (PDQ"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282ff6275","article-title":"Persistent Kaposi sarcoma in the era of highly active antiretroviral therapy: characterizing the predictors of clinical response","volume":"22","author":"Nguyen","year":"2008","journal-title":"AIDS"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282fc9c03","article-title":"Predicting the evolution of Kaposi sarcoma, in the highly active antiretroviral therapy era","volume":"22","author":"El Amari","year":"2008","journal-title":"AIDS"},{"key":"B32","volume-title":"Penile Cancer","author":"Engelsgjerd","year":"2023"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61178-1","article-title":"Cancer of unknown primary site","volume":"379","author":"Pavlidis","year":"2012","journal-title":"Lancet"},{"key":"B34","article-title":"Cancer of unknown primary site","volume-title":"DeVita, Hellman, and Rosenberg\u2019s Cancer: Principles and Practice of Oncology","author":"Greco","year":"2018"},{"key":"B35","unstructured":"Cancer staging"},{"key":"B36","unstructured":"LeeS\n          Canadian Cancer SocietyPrognosis and survival for penile cancer"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.49","article-title":"Stage at diagnosis and early mortality from cancer in England","author":"McPhail","year":"2015","journal-title":"Br J Cancer"},{"key":"B38","unstructured":"Tumor grade"},{"key":"B39","unstructured":"Pew Research Center\u2019s Social & Demographic Trends ProjectA rising share of U.S. adults are living without a spouse or partner2021"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.7150\/jca.32037","article-title":"Marital status and survival in patients with penile cancer","volume":"10","author":"Mao","year":"2019","journal-title":"J Cancer"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1037\/a0034528","article-title":"Social relationships and allostatic load in the MIDUS study","volume":"33","author":"Brooks","year":"2014","journal-title":"Health Psychol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2020.100642","article-title":"Life expectancy and active life expectancy by marital status among older U.S. adults: Results from the U.S. Medicare Health Outcome Survey (HOS)","volume":"12","author":"Jia","year":"2020","journal-title":"SSM Popul Health"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0211894","article-title":"Living arrangements and disability-free life expectancy in the United States","volume":"14","author":"Chiu","year":"2019","journal-title":"PloS One"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.51.5080","article-title":"Marriage is as protective as chemotherapy in cancer care","author":"Kissane","year":"2013","journal-title":"J Clin Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1271913\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T11:33:28Z","timestamp":1698752008000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1271913\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":44,"alternative-id":["10.3389\/fonc.2023.1271913"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1271913","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]},"article-number":"1271913"}}