Response to comment on: Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old

The comment by Vandermaesen K and Albersen M [1] on our recent study on the oncological outcomes of penile squamous cell carcinoma (SCC) in a ≤50 years (younger) and >50 years (older) cohort of men [2] raised important points for areas of further research.

Correctly identified, the intentionally matched cohorts based on the stage of disease and surgical technique would limit a comprehensive evaluation of histopathological characteristics between the younger and older groups of men. However, the aim of our study was not to investigate this, but to understand whether the two groups of patients with similar stage of disease and surgical treatment would have different survival outcomes. We found that there were no differences in outcomes, except for overall survival. It is likely, as pointed out by Vandermaesen K and Albersen M [1] that the lower overall survival rate observed in the older cohort is associated with higher comorbidities. However, we did not compare data on comorbidities or Charlson scores to prove this. The observation that similar cancer staging in both age groups resulted in similar cancer-specific survival, recurrence-free and metastatic-free survivals implied that penile SCC in the younger patients is at least as aggressive as in older patients and should not be underestimated.