EPIDEMIOLOGIC STUDY ON PENILE CANCER IN RIO GRANDE DO NORTE -BRAZIL

Introduction: Penile cancer is an aggressive and rare disease, with incidence less than 1% of male malignancies in the US and Europe. However, the incidence reaches 10% in developing countries such as Africa and South America. In Brazil, penile cancer stands for 2% of the tumor types, one of the worlds highest incidence rates for this neoplasia, especially in regions of the North and Northeast. There are several causes related to the development of penile cancer, such as socioeconomic level and precarious conditions of personal hygiene and HPV infections. Due to the rarity, there are few clinical data in the literature on this type of cancer. Objectives: The objective is to trace the clinical-epidemiological profile of penile cancer in Rio Grande do Norte and correlate it with Brazilian data and world literature. As well as evaluating prognostic factors and overall survival. Methodology: This is an epidemiologic study based on the analysis of 94 medical records of patients with a histopathological diagnosis of penile neoplasia treated in an institute of reference in Rio Grande do Norte between 2011 and 2018. Results and Discussion: According to the analysis, 72.2% of the patients are from country side versus 27.8% are from the capital; 81.4% were 50 years of age or older. The majority of cases occurred between 50 and 70 years, increasing the incidence by age; 66.7% were brown and 84.1% were illiterate or had incomplete elementary education. The majority of patients were diagnosed in the early stage of disease, in stages: I (21.3%), IIA (27.7%) and IIB (19.1%). In 20.2% of cases, the neoplasia was diagnosed in stage IV, leading to decreased survival and higher mortality rates. Almost half of the patients (47.9%) were submitted to partial penectomy and 20.8% to partial penectomy with inguinal lymphadenectomy. About 10% of the patients received treatment with adjuvant or palliative radiotherapy or chemotherapy. Furthermore, 8.6% of patients progressed with distant metastasis, mainly for lymph nodes (87.5%), lungs and bones (12.5%). The median follow-up was 18 months, with overall 5-year survival of 59.1%. Conclusion: Penile cancer is a very frequent pathology in Brazil, the worst prognosis is related to a delay in obtaining specialized medical assistance. This study aims to contribute to the construction of an epidemiological map of penile cancer in state of Rio Grande do Norte and Brazil, population awareness with prevention, early diagnosis and treatment.