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International Urology and Nephrology

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01-04-2019 | Lymphadenectomy | Urology - Original Paper

More lymph node dissection improves survival in patients with newly diagnosed lymph node-positive penile cancer

Authors: Weipu Mao, Xin Huang, Minghao Kong, Jie Fan, Jiang Geng

Published in: International Urology and Nephrology | Issue 4/2019

Abstract

Purpose

For patients with lymph node-positive (LN+) penile cancer, the optimal extent of lymph node dissection (LND) is currently not established. We aimed to reveal the potential association between survival and the number of LND in patients with newly diagnosed LN + penile cancer.

Methods

Patients with LN + penile cancer diagnosed between 2004 and 2015 were identified using the SEER database. The relationships between the number of removed lymph nodes and overall survival (OS), all-cause mortality (ACM), cancer-specific mortality (CSM), and 5-year mortality were tested. Kaplan–Meier curves as well as univariate and multivariable cox regression were used to further analyze disparities in mortality and survival.

Results

Among 599 eligible patients with LN + penile cancer, 527 (88.0%) received surgery and 72 (12.0%) did not. Compared with those who had not received surgery, patients receiving surgery had longer overall survival (28.31 ± 30.84 versus 16.69 ± 21.68 months) and longer median survival (15.00 versus 8.00 months) times. Univariate analyses demonstrated the number of LND to be an independent factor. Multivariable Cox regression analyses suggested that the ≥ 8 removed lymph nodes predicted a lower ACM rate (hazard ratio (HR) = 0.48, 95% CI 0.38–0.61, p < 0.001), penile CSM rate (HR = 0.42, 95% CI 0.30–0.57, p < 0.001), and lower 5-year mortality (HR = 0.58, 95% CI 0.47–0.71, p < 0.001).

Conclusions

In patients with newly diagnosed LN + penile cancer, more LND during lymphadenectomy was associated with an improvement in ACM, CSM rate, and 5-year mortality. Therefore, patients with preoperatively LN + penile cancer should undergo LND to have more lymph nodes removed.

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Title: More lymph node dissection improves survival in patients with newly diagnosed lymph node-positive penile cancer
Authors: Weipu Mao
Xin Huang
Minghao Kong
Jie Fan
Jiang Geng
Publication date: 01-04-2019
Publisher: Springer Netherlands
Keywords: Lymphadenectomy
Penile Cancer
Penile Cancer
Published in: International Urology and Nephrology / Issue 4/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-019-02084-7

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