Pattern of invasion is the most important prognostic factor in patients with penile cancer submitted to lymph node dissection and pathological absence of lymph node metastasis (pN0) - Abstract

OBJECTIVES: Penile carcinoma (PC) is a rare neoplasm in European countries, of which the presence of lymph node metastasis is the most important prognostic factor.

Few studies have examined PC patients with histologically negative nodes (pN0). The aim of this study was to identify the prognostic factors in a cohort of pN0 PC patients.

SUBJECTS AND METHODS: One hundred one patients with PC met the inclusion criteria-47 (46.5%) patients underwent bilateral inguinal lymph node dissection, and 54 (53.5%) subjects underwent bilateral inguinopelvic lymph node dissection. Variables that had a prognostic impact on survival rates in the univariate analysis were selected for multivariate survival analysis.

RESULTS: The cohort cancer-specific survival (CSS) and overall survival (OS) rates were 88.1% and 52.5%, respectively. Histological grade and pattern of invasion were the only features to significantly impact survival rates in the univariate analysis. The CSS and OS rates in patients with pushing versus infiltrating patterns of invasion were 98.0% versus 78.4% (p=0.003) and 70.0% versus 35.3% (p=0.005), respectively. Pattern of invasion was the only independent predictor of survival. Patients with infiltrating invasion had a higher probability of death from cancer (HR 11.5, P = 0.019) and overall death (HR 2.3, P = 0.007) compared with those with a pushing invasion pattern.

CONCLUSIONS: The presence of an infiltrating pattern of invasion is the most important predictor of survival in PC patients. We encourage other centers to confirm our findings that the pattern of invasion is an important prognostic factor in patients with PC and pN0 disease.

Written by:
Aita G, da Costa WH, de Cassio Zequi S, da Cunha IW, Soares F, Guimaraes GC, Lopes A.   Are you the author?

Reference: BJU Int. 2015 Jan 30. Epub ahead of print.
doi: 10.1111/bju.13071


PubMed Abstract
PMID: 25639616

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