Identifying an optimal lymph node yield for penile squamous cell carcinoma: prognostic impact of surgical dissection. BJU international

Juan Chipollini, Mounsif Azizi, Salvatore Lo Vullo, Luigi Mariani, Yao Zhu, Ding W. Ye, Antonio Augusto Ornellas, Nick Watkin, Michael Ager, Oliver Hakenberg, Axel Heidenreich, Daniele Raggi, Mario Catanzaro, Paulo Ornellas, Roberto Salvioni, Salim K. Cheriyan, Andrea Necchi, Phillippe E. Spiess

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To evaluate the prognostic impact of lymph node yield (LNY) on survival outcomes for penile squamous cell carcinoma (SCC). PATIENTS AND METHODS: In all, 532 patients who underwent inguinal LN dissection (ILND) across tertiary referral centres from Europe, China, Brazil and North America were retrospectively evaluated. From this cohort, 198 patients received pelvic LND (PLND).We identified threshold values for ILND and PLND using receiver operating characteristic curves. We tested prognostic value of LNY for recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) using the Kaplan-Meir method and Cox proportional hazard regression models. RESULTS: The median (interquartile [IQR]) age was 59 (49-68) years and the median (IQR) follow-up after ILND was 28 (12-68.2) months. Overall, 85% of the patients had bilateral dissections. The median (IQR) number of inguinal LNs removed was 15 (10-22). Of those receiving PLND, The median (IQR) number of LNs was 13 (8-19). A LNY of ≥15 was used for dichotomisation of ILND patients, and a LNY of ≥9 was used in the PLND cohort. Patients with a LNY ≥15 had significantly better 5-year OS vs patients with a LNY
Original languageEnglish
Pages (from-to)82-88
Number of pages7
JournalBJU International
Volume125
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Humans
  • Male
  • Middle Aged
  • Survival Rate
  • Aged
  • Lymphatic Metastasis
  • Prognosis
  • Retrospective Studies
  • *#PenileCancer
  • *survival
  • *lymphadenectomy
  • Carcinoma, Squamous Cell/mortality/secondary/*surgery
  • Inguinal Canal
  • Lymph Node Excision/*statistics & numerical data
  • Penile Neoplasms/mortality/pathology/*surgery

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