The World Health Organization 2016 classification of penile carcinomas: a review and update from the International Society of Urological Pathology expert driven recommendations

Abstract

The International Society of Urological Pathology (ISUP) held an expert driven penile cancer conference in Boston in March 2015 which focused on the new WHO classification of penile cancer: HPV-related tumors and histological grading. The conference was preceded by an online survey of the International Society of Urological Pathology members and the results were used to initiate discussions. Because of the rarity of penile tumors, this was not a consensus but an expert driven conference aiming to assist pathologists who do not see these tumor on a regular basis. After a justification for the novel separation of penile squamous cell carcinomas into HPV- and non-HPV-related-carcinomas, the histologic classification of penile carcinoma was proposed; this system was also accepted subsequently by the WHO for subtyping penile carcinomas (2016). A description of HPV-related neoplasms, which may be recognized by their histological features, was presented and p16 was recommended as a surrogate indicator of HPV. A three-tier grading system was recommended for penile squamous carcinomas; this was also adopted by the WHO (2016). Many of the distinctive histologic subtypes of squamous cell carcinoma of the penis are associated with distinct grades, based on the SCC subtype histological features.

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