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01-03-2016 | Original Article

Extent of pelvic lymph node dissection in penile cancer may impact survival

Authors: Kamran Zargar-Shoshtari, Pranav Sharma, Rosa Djajadiningrat, Mario Catanzaro, Ding-Wei Ye, Yao Zhu, Nicola Nicolai, Simon Horenblas, Philippe E. Spiess

Published in: World Journal of Urology | Issue 3/2016

Abstract

Introduction

Current guidelines on management of penile carcinoma (PC) recommend ipsilateral pelvic lymph node dissection (PLND) in patients with inguinal lymph node metastasis (LNM) who meet specific criteria. The aim of this article was to assess outcomes in patients treated with bilateral PLND in the presence of unilateral metastatic pelvic nodes.

Methods

After IRB approval, four international centers contributed to this study. Men with PC and unilateral inguinal LNM and pelvic node metastases were retrospectively analyzed. Estimates of overall survival (OS) and cancer-specific survival were provided by the Kaplan–Meier method. Comparisons between subgroups were made using the log-rank test, and Cox regression analysis was used to adjust comparisons for covariates of interest.

Results

From 1978 to 2012, fifty-one men with unilateral inguinal LNM and positive pelvic nodes on PLND were identified. Thirty-eight (75 %) had ipsilateral and 13 (25 %) had bilateral PLND. Except the extent of the PLND, patients were comparable with respect to disease and therapeutic interventions. The Kaplan–Meier estimated median OS was significantly longer in the bilateral PLND patients (21.7 vs. 13.1, p = 0.051). On Cox regression analysis, bilateral PLND [HR 0.25, (95 % CI 0.10–0.64)], multiple pelvic node involvement [HR 2.12 (95 % CI 1.02–4.43)], neoadjuvant chemotherapy [HR 0.01, (95 % CI 0.02–0.44)] and adjuvant therapies [HR 0.16, (95 % CI 0.06–0.45)] (compared to no additional therapy) were independent predictors of OS.

Conclusions

Men with PC and pelvic node metastases may benefit from a bilateral PLND. This hypothesis requires further confirmation.

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Title: Extent of pelvic lymph node dissection in penile cancer may impact survival
Authors: Kamran Zargar-Shoshtari
Pranav Sharma
Rosa Djajadiningrat
Mario Catanzaro
Ding-Wei Ye
Yao Zhu
Nicola Nicolai
Simon Horenblas
Philippe E. Spiess
Publication date: 01-03-2016
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 3/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1593-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extent of pelvic lymph node dissection in penile cancer may impact survival

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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