Factors predicting inguinal node metastasis in squamous cell cancer of penis

Bhagat, Suresh K.; Gopalakrishnan, Ganesh; Kekre, Nitin S; Chacko, Ninan; Kumar, Santosh; Manipadam, M.T.; Samuel, Prasanna

doi:10.1007/s00345-009-0421-1

Cited by 32 publications

(12 citation statements)

References 18 publications

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“…Bhagat et al. analysed 106 patients with penile cancer to construct a nomogram. Age, grade, lymphovascular invasion and clinically palpable lymph nodes were included; however, age did not prove to be a significant predictor despite its inclusion in the model, as was similarly found in the present analysis.…”

Section: Discussionmentioning

confidence: 99%

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

et al. 2019

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ObjectiveTo evaluate the predictive nature of several clinicopathological variables by developing a nomogram predictive for lymph node-positive disease using the National Cancer Database cohort of patients with squamous cell carcinoma of the penis. MethodsStepwise logistic regression was used to find the best-fit model; remaining clinical variables were used to create a nomogram to predict the probability of lymph node-positive disease. ResultsOn multivariate analysis, high pathological grade (3-4 vs 1: odds ratio [OR] 3.27, 95% confidence interval [CI] 1.70-6.29; 2 vs 1: OR 2.58, 95% CI 1.39-4.79 [P = 0.002]), lymphovascular invasion (OR 2.49, 95% CI 1.61-3.84 [P < 0.001]), and positive clinical lymph node status (N1 vs N0: OR 20.0, 95% CI 11.4-35.7; N2 vs N0: OR 27.8, 95% CI 14.1-55.6; N3 vs N0: OR 49.2, 95% CI 14.8-162.8 [P < 0.001]) were predictors of lymph node metastasis in penile cancer. The bootstrap-corrected concordance index of this nomogram was 0.880. ConclusionUsing tumour grade, tumour lymphovascular invasion and clinical lymph node status, we developed a nomogram highly predictive of pathologial lymph node metastasis that, after further external validation, could be helpful in the surgical decision-making process.

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Section: Discussionmentioning

confidence: 99%

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

et al. 2019

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“…However, morbidity related to the procedure is one factor that leads this options less desirable in all. 21 Our series contained fewer patients with lymph node dissection. This is probably due to patients losing follow up after satisfactory treatment of the primary penile growth not realizing the prognosis in the absence of second procedure, or on physicians' part who were unable to convince patient for the second staged procedure.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Pattern of Penile Cancer in a Tertiary Care Centre in Nepal

et al. 2015

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Introduction: Carcinoma of penis is an uncommon entity. The higher incidence in developing country may be because of poor hygiene, less common practice of circumcision and unsafe sexual practice. Timely diagnosis and intervention gives the patient a chance of cure. Data on penile cancer is sparse from Nepal so treatment of penile cancer in our centre is presented here. Methods: This was a retrospective cross-sectional study done at Urology unit of Department of Surgery of Tribhuvan University Teaching Hospital, Nepal from November, 2007 to December, 2013. Data was retrieved from case records and those with penile carcinoma were included. Patient demographics, lesion characteristics, mode of treatment with outcome measures were noted and analyzed. Results: Total 17 patients underwent treatment for primary penile lesion. Mean age of the patients was 51.5 years. Penile growth was the most frequent presentation with five patients coming with more than one symptom. The most common site was over glans of penis (n=13) with the mean size of 3.55 cm. Partial penectomy was offered in 16 with one patient undergoing circumcision only. Inguinal lymph node dissection was done in four patients. Squamous cell carcinoma was the histological diagnosis in 15 patients. Conclusions: Penile carcinoma is primarily a disease of old. Growth over glans penis is the most common presentation and partial penectomy is feasible in most of the patients to allow oncological cure while preserving the organ for its native function. Keywords: inguinal lymph node dissection; partial penectomy; penile cancer.

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“…5,10 Therefore, inguinal lymphadenectomy continues to be the best technique to detect LN involvement, enabling the proper staging of the disease, which has a positive impact in the survival rate of patients in a 5-year period. 22,23,29 Such results can be achieved especially when the disease is in a nodal stage lower than pN2, without any extra capsular involvement of the nodule and unilateral affectations without any compromise of the pelvic LNs, cases in which a survival rate of 80% was observed. 17,18 The study of this topic is of particular relevance when considering that 20% of the patients clinically staged as negative for cancerous cells present hidden metastases, while 77% of the patients with high-risk SCCP have negative lymphadenectomies that are negative for LN involvement.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Inguinal Lymph Node Involvement and Tumor Recurrence in Squamous Cell Carcinoma of the Penis

Ramos

Ramirez

Varela

et al. 2020

Revista Urología Colombiana / Colombian Urology Journal

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Introduction Penile carcinoma is an aggressive disease with catastrophic consequences that frequently lead to death. Therefore, further knowledge on the prognostic factors that can help identify patients in need of more aggressive treatments becomes essential. Objective To identify the prognostic factors for lymph node (LN) involvement and tumor recurrence in patients diagnosed with squamous cell carcinoma of the penis (SCCP). Methods A retrospective cohort study was conducted. Patients diagnosed and treated for SCCP at Instituto Nacional de Cancerología between 2008 and 2015 were included in the sample. Cases in which no information on recurrence was available for the follow-up were excluded, as well as patients with no initial pathology and those getting penile reconstructions after cancer.Relevant data was retrieved from the medical records of each patient, and a descriptive analysis was performed. Subsequently, this data was used to apply a logistic regression model to determine the potential clinical and histopathological prognostic factors. Results A total of 104 patients were included in the present study. The average age of the sample was 59 years, while the follow-up averaged 24 months per patient. Inguinal lymphadenectomy was performed on 61 patients (59%) during the follow-up. The logistic regression model showed that lymphovascular invasion (odds ratio [OR]: 6.7; 95% confidence interval [95%CI]: 1.2–35) and poor tumor differentiation (OR: 17; 95%CI: 3.2–92) were associated with tumor recurrence. Likewise, the lymphadenectomy procedures showed that lymphovascular invasion was associated with LN involvement (OR: 3.3; 95%CI: 1.1–10). Conclusion Lymphovascular invasion was the strongest prognostic factor observed in our sample, aiding in the prediction of inguinal LN involvement and tumor recurrence in SCCP patients.

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Factors predicting inguinal node metastasis in squamous cell cancer of penis

Abstract: High grade and LVI in the tumor along with clinical stage of the inguinal nodes were the strongest predictors of metastasis. These features helped us to develop a nomogram to predict and to identify patients at risk of nodal metastasis.

Cited by 32 publications

References 18 publications

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

Clinicopathological Pattern of Penile Cancer in a Tertiary Care Centre in Nepal

Prognostic Factors for Inguinal Lymph Node Involvement and Tumor Recurrence in Squamous Cell Carcinoma of the Penis

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