Hussain M. Alnajjar

Objective To report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC). Patients and Methods A retrospective analysis of men with penile sSCC diagnosed between January 2010 and January 2020 in a single centre was conducted. Disease‐specific (DSS), recurrence‐free (RFS) and metastasis‐free (MFS) survival were evaluated. Outcomes were compared with a non‐sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan–Meier plots were used to estimate survival outcomes. Results In all, 1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (interquartile range) age and follow‐up was 70 (57–81) years and 16 (7–44) months, respectively. Operations performed included: circumcision, one (2.6%); wide local excision, four (10.5%); glansectomy, 11 (29%); partial penectomy, 10 (26%); subtotal/total penectomy, 12 (32%). The Kaplan–Meier estimated 12‐, 24‐ and 36‐month DSS was 62% (vs non‐sarcomatoid, 67%), 43% (vs non‐sarcomatoid, 67%) and 36% (vs non‐sarcomatoid, 67%), respectively ( P = 0.03). The Kaplan–Meier estimated 12‐ and 24‐month RFS was 47% (vs non‐sarcomatoid, 60%) and 28% (vs non‐sarcomatoid, 55%), respectively ( P = 0.01). The MFS was 52% (vs non‐sarcomatoid, 62%) at 12 months and 37% (vs non‐sarcomatoid, 57%) at 24 months ( P = 0.04). Conclusions Sarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.