Scrotal cancer survival is influenced by histology: a SEER study

Introduction Due to the scrotum’s multiple layers of different tissues, scrotal cancer can present with several unique histologies. Historically, outcome arising from these different sources has been historically aggregated together. However, it remains unclear whether survival differs by histology of scrotal cancer. Methods We queried the seventeen registries of the Surveillance, Epidemiology, and End Results database for patients diagnosed with primary scrotal cancer from 1973 to 2006. Patients were initially grouped by the following histologies: basal cell carcinoma, Extramammary Paget’s Disease (EMPD), sarcoma, melanoma, squamous cell carcinoma, and adnexal skin tumors. For some analyses, the former three histologies were reclassified as Low-Risk scrotal cancer and the latter three histologies as High-Risk scrotal cancer. Kaplan–Meier survival analyses were conducted to assess the impact of histology on overall survival (OS). Results The cohort consisted of 766 patients. Median (95% CI) OSs by histologies were basal cell carcinoma—143 (116–180), EMPD—165 (139–190), sarcoma—180 (141–219), melanoma—136 (70–203), squamous cell carcinoma—115 (97–133), and adnexal skin tumors—114 (55–174). Patients with Low-Risk scrotal cancer experienced a median (95% CI) OS of 166 (145–188) months, while patients with High-Risk scrotal cancer experienced a median (95% CI) OS of 118 (101–135) months. Conclusions Survival of scrotal cancer depends on tumor histology. Classification of histologies into Low and High Risk can be clinically useful for counseling and clinical decisions.