We determined whether a clinicopathological nomogram is able to predict the risk of pelvic lymph node metastasis (LNM) in penile cancer patients after inguinal lymph node dissection (ILND).
Ninety-eight patients with bilateral ILND who underwent pelvic lymphadenectomy at 10 centers were retrospectively analyzed. The most predictive features in the nomogram were selected by the stepwise logistic regression method and then tested and verified by multivariate logistic regression analyses. The nomogram was assessed using concordance indices and calibration curves.
Of the 181 pelvic basins, pelvic LNM was observed in 52 packages (43 patients). Bilateral pelvic LNM was present in 9 patients (9/43, 20.9%). There was no crossover metastatic spread from one inguinal side to the other pelvic side. Age, previous resection, the biopsy procedure for inguinal lymph nodes, vascular invasion, and ipsilateral inguinal lymph node status were all independent risk factors for pelvic LNM (all P < 0.05) in the multivariate logistic regression analysis. The nomogram exhibited a good probability for survival agreement, with a concordance index of 0.868 (95% CI: 0.813-0.922).
A novel nomogram suggests that the risk of pelvic LNM can be effectively predicted in penile carcinoma patients and may provide a useful guide for clinicians. Further external validation is needed.
Urologic oncology. 2021 Feb 20 [Epub ahead of print]
Zaishang Li, Hui Han, Xueying Li, Yonghong Li, Chong Wu, Fangjian Zhou
Department of Urology, Shenzhen People's Hospital, The Second Clinic Medical College of Jinan University, Shenzhen, Guangdong, People's Republic of China; Department of Urology, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.; Minimally Invasive Urology of Shenzhen Research and Development Center of Medical Engineering and Technology, Shenzhen, Guangdong, People's Republic of China., Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People's Republic of China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China. Electronic address: ., Department of Oncology, The Seventh Affiliated Hospital Sun Yat-sen University, Shenzhen, Guangdong, People's Republic of China., Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People's Republic of China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China., Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China; State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, People's Republic of China; Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China. Electronic address: .