Our primary objective is to detail the incidence, site, and timing of pSCC recurrence after ILND.
Retrospective analysis of 551 patients who underwent ILND for pSCC, from 2000 to 2017. The primary outcome was pSCC recurrence after ILND. Recurrences were identified and stratified by site. Timing of recurrence was determined. Multivariable logistic regression analysis determined associations with recurrence. Multivariable Cox regression analysis determined associations with overall survival (OS). Sub-group analysis of the distant recurrences analyzed timing, and OS by site of distant recurrence.
176 (31.9%) recurred after ILND. Median time to recurrence was 10 months for distant recurrences, 12 for inguinal, 10.5 for pelvic, and 44.5 for local. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months of ILND, versus 127 months for local recurrences. Post-ILND recurrence was associated with with pN2 (OR 1.99, 95 CI 1.0-4.1), and pN3 (OR 7.2, 95 CI 4.0-13.7). Patients who had local recurrence had similar OS to those without (HR 1.5, 95 CI 0.6-3.8), and worse OS was identified in patients with inguinal (HR 4.5, 95 CI 2.8-7.1), pelvic (HR 2.6, 95 CI 1.5-4.5), or distant (HR 4.0, 95 CI 2.7-5.8) recurrences. Patients with lung recurrences had worse OS than other sites (HR 2.2, 95 CI 1.1-4.3).
31.9% of patients had post-ILND recurrence associated with high pN staging. Greater than 95% of distant, inguinal, and pelvic recurrences occurred within 48 months, suggesting surveillance beyond this is low yield. Local recurrences occurred over a longer timeline, emphasizing necessity of long-term surveillance of the primary site.
The Journal of urology. 2021 May 25 [Epub ahead of print]
Nicholas H Chakiryan, Aaron Dahmen, Marco Bandini, Filippo Pederzoli, Laura Marandino, Maarten Albersen, Eduard Roussel, Yao Zhu, Ding-Wei Ye, Antonio A Ornellas, Mario Catanzaro, Oliver W Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Jad Chahoud, Alberto Briganti, Roberto Salvioni, Francesco Montorsi, Andrea Necchi, Philippe E Spiess
H Lee Moffitt Cancer Center, Department of Genitourinary Oncology, Tampa, Florida., University of South Florida, Department of Urology, Tampa, Florida., Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy., University Hospitals Leuven, Leuven, Belgium., Fudan University Shanghai Cancer Center, Shanghai, China., Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil., University Hospital Rostock, Rostock, Germany., Universitätsklinikum Köln, Köln, Germany., St. George's University Hospitals, NHS Foundation Trust, London, UK.