TY - JOUR
T1 - Lymph node yield as a predictor of overall survival following inguinal lymphadenectomy for penile cancer
AU - Soodana-Prakash, Nachiketh
AU - Koru-Sengul, Tulay
AU - Miao, Feng
AU - Lopategui, Diana M.
AU - Savio, Luis F.
AU - Moore, Kevin J.
AU - Johnson, Taylor A.
AU - Alameddine, Mahmoud
AU - Barboza, Marcelo Panizzutti
AU - Parekh, Dipen J.
AU - Punnen, Sanoj
AU - Gonzalgo, Mark L.
AU - Ritch, Chad R.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Objective: To determine whether a specific lymph node yield (LNY) affects overall survival (OS) in patients with penile cancer. Materials and Methods: Using the National Cancer Database, we identified 364 men diagnosed with pSCC who underwent ILND between 2004 and 2013. Men diagnosed on autopsy or at the time of death, patients with preoperative chemotherapy or radiotherapy, M+ and N3 disease, or with less than 3-month of follow-up were excluded. Kaplan-Meier analysis was used to compare Overall Survival (OS). A multivariable Cox regression model was developed to assess predictors of OS. Results: The median number of LN retrieved was 16 (IQR: 9-23). There was no significant difference in race, stage, grade for men with LNY ≤15 vs. >15. However, men with LNY ≤15 were significantly older than those with LNY >15 (65 vs. 59 years, p<0.001). On multivariable analysis, radical surgery, age, N+ disease, and LNY ≤15 were independent predictors of worse OS. Patients with LNY ≤15 showed significantly worse 5-year OS versus those with LNY >15 (49% vs. 67%, p=0.008). Nodal density (ND) ≥12.5% was also associated with decreased 5-year OS versus ND <12.5% (31% vs. 70%, p<0.0001). Conclusions: LNY following ILND for pSCC appears to be an independent predictor of OS. A total LNY of >15 following ILND may have a beneficial impact on OS and serve as the threshold for defining an adequate ILND.
AB - Objective: To determine whether a specific lymph node yield (LNY) affects overall survival (OS) in patients with penile cancer. Materials and Methods: Using the National Cancer Database, we identified 364 men diagnosed with pSCC who underwent ILND between 2004 and 2013. Men diagnosed on autopsy or at the time of death, patients with preoperative chemotherapy or radiotherapy, M+ and N3 disease, or with less than 3-month of follow-up were excluded. Kaplan-Meier analysis was used to compare Overall Survival (OS). A multivariable Cox regression model was developed to assess predictors of OS. Results: The median number of LN retrieved was 16 (IQR: 9-23). There was no significant difference in race, stage, grade for men with LNY ≤15 vs. >15. However, men with LNY ≤15 were significantly older than those with LNY >15 (65 vs. 59 years, p<0.001). On multivariable analysis, radical surgery, age, N+ disease, and LNY ≤15 were independent predictors of worse OS. Patients with LNY ≤15 showed significantly worse 5-year OS versus those with LNY >15 (49% vs. 67%, p=0.008). Nodal density (ND) ≥12.5% was also associated with decreased 5-year OS versus ND <12.5% (31% vs. 70%, p<0.0001). Conclusions: LNY following ILND for pSCC appears to be an independent predictor of OS. A total LNY of >15 following ILND may have a beneficial impact on OS and serve as the threshold for defining an adequate ILND.
KW - Inguinal lymphadenectomy
KW - Lymph node dissection
KW - Lymph node yield
KW - National Cancer Database
KW - Penile cancer
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U2 - 10.1016/j.urolonc.2018.07.010
DO - 10.1016/j.urolonc.2018.07.010
M3 - Article
AN - SCOPUS:85051736597
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
SN - 1078-1439
ER -