Prognostic Factors for Occult Inguinal Lymph Node Involvement in Penile Carcinoma and Assessment of the High-Risk EAU Subgroup: A Two-Institution Analysis of 342 Clinically Node-Negative Patients

Graafland, Niels M.; Lam, Wayne; Leijte, Joost A.P.; Yap, Tet; Gallee, M.P.W.; Corbishley, Cathy; Werkhoven, Erik van; Watkin, Nick; Horenblas, Simon

doi:10.1016/j.eururo.2010.08.015

Cited by 130 publications

(48 citation statements)

References 27 publications

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“…Its incidence in the United States is affected by race and ethnicity, being low for Asian-Pacific Islanders and American Indians and highest for Hispanics and Southern Blacks [1,2]. The most important prognostic factor in SCC of the penis is inguinal lymph node involvement [2,3]. Optimal management of patients with impalpable or even palpably enlarged nodes has been under debate for many years [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Optimal management of patients with impalpable or even palpably enlarged nodes has been under debate for many years [4,5]. Various approaches advocated in the past include close surveillance, dynamic sentinel node biopsy, modified lymphadenectomy, and risk-adapted or elective lymphadenectomy [3,6]. Each approach has its advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

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Elevated C-reactive protein values predict nodal metastasis in patients with penile cancer

et al. 2013

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BackgroundThe nodal status is a strong predictor for cancer specific death in patients with penile carcinoma, and the C-reactive protein (CRP) level at diagnosis has recently been shown to be associated with poor clinical outcome in various solid malignancies. Therefore, this retrospective study was performed to evaluate the association between preoperative CRP levels and the incidence of nodal metastasis in patients with squamous cell carcinoma (SCC) of the penis.MethodsThe analysis included 51 penile cancer patients who underwent either radical or partial penectomy for pT1-4 penile cancer between 1990 and 2010. The nodal status was correlated with patient and tumor specific characteristics.ResultsSixteen (31%) patients had lymph node metastasis at the time of penile cancer surgery. Nodal status was associated with tumor stage but did not correlate significantly with tumor grade. In contrast, high presurgical CRP levels were significantly associated with the diagnosis of nodal involvement (p = 0.04). The optimal CRP cut-off value to predict lymph node metastasis was set at 20 mg/l based on ROC analysis.ConclusionsSince a high preoperative serum CRP level was closely correlated with nodal disease, it could be used as an additional marker to help identify patients with penile cancer who may benefit from inguinal lymph node dissection.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Elevated C-reactive protein values predict nodal metastasis in patients with penile cancer

et al. 2013

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“…The best treatment option for nodal metastasis is regional lymphadenectomy. A number of studies investigated the risk factors for nodal metastases with the most important being tumour grade and lymphovascular invasion 14. However, a proportion of patients still undergo over-treatment of their inguinal lymph nodes, which is associated with several complications 15–17.…”

Section: Introductionmentioning

confidence: 99%

The prognostic value of Ki-67 expression in penile squamous cell carcinoma

Stankiewicz¹,

Cuzick

et al. 2012

J Clin Pathol

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“…38 For pT1 disease with LVI (pT1b), pT2-pT4, or G3 or G4 penile cancer, the risk of occult micrometastatic inguinal LN involvement can be as high as 20%-30% in clinically normal groins. 39,40 As early prophylactic bilateral ILND in clinically node-negative patients at intermediate (pT1b) or high risk (pT2-pT4, G3 or G4) for inguinal LN disease results in superior long-term survival compared with early radiotherapy or surveillance (5-year overall survival: 74% vs 66% vs 63%, respectively), it is recommended in this setting. 41 Delaying ILND until groins are clinically positive or until the development of regional recurrence results in worse outcomes in men with intermediate or high-risk penile tumors (5-year cancer-specific survival [CSS]: 16%-45%).…”

Section: Surgical Treatment Of Nonpalpable Ilnsmentioning

confidence: 98%