Zai-Shang Li1,2,3, Chuang-Zhong Deng1,2,3, Kai Yao1,2,3, Yong Tang4, Nan Liu5, Peng Chen6, Bin Wang7, Xiang Li8, Xiao-Feng Chen9, Hong Liao10, Qi-Wu Mi11, Yong-Hong Lei12, Qi Zhao2,3,13, Pei-Zhen Zhao14, Xue-Ying Li2,3,15, Jie-Ping Chen1,2,3, Qiang-Hua Zhou1,2,3, Zi-Ke Qin1,2,3, Zhuo-Wei Liu1,2,3, Yong-Hong Li1,2,3, Yun-Lin Ye1,2,3, Hua Tu1,2,3, Zi-Jun Zou7, Xing Bi6, Feng Yang6, Ying-Ming Xiao10, Jing Li7, Xiang-Tian Lin16, Wei-Cong Liang16, Hui Han17,18,19, Fang-Jian Zhou20,21,22. 1. Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. 2. State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China. 3. Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China. 4. Department of Urology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, People's Republic of China. 5. Department of Urology Oncological Surgery, Chongqing Cancer Hospital and Institute and Cancer Center, Chongqing, China. 6. Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümchi, People's Republic of China. 7. Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, People's Republic of China. 8. Department of Urology, West China Hospital of Sichuan University, Chengdu, People's Republic of China. 9. Department of Urology, The First People's Hospital of Chenzhou, Chenzhou, People's Republic of China. 10. Department of Urology, Sichuan Cancer Hospital, Chengdu, People's Republic of China. 11. Department of Urology, Dong Guan People's Hospital, Dongguan, People's Republic of China. 12. Department of Urology, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China. 13. School of Life Science, Sun Yat-Sen UniversitySchool of Life Science, Guangzhou, People's Republic of China. 14. Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, People's Republic of China. 15. Department of Medical Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, People's Republic of China. 16. Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China. 17. Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. hanhui@sycucc.org.cn. 18. State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China. hanhui@sycucc.org.cn. 19. Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China. hanhui@sycucc.org.cn. 20. Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. Zhoufj@sycucc.org.cn. 21. State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China. Zhoufj@sycucc.org.cn. 22. Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China. Zhoufj@sycucc.org.cn.
Abstract
BACKGROUND: Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients. METHODS: Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis. RESULTS: In this study, the Kaplan-Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2 patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3 patients (P = 0.417) with comparable DSS. CONCLUSION: Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.
BACKGROUND: Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients. METHODS: Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinomapatients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis. RESULTS: In this study, the Kaplan-Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3patients (P = 0.417) with comparable DSS. CONCLUSION: Bilateral PLND may improve survival in pN2patients. Men with pN3 may not benefit from bilateral PLND.
Authors: Oliver W Hakenberg; Eva M Compérat; Suks Minhas; Andrea Necchi; Chris Protzel; Nick Watkin Journal: Eur Urol Date: 2014-11-01 Impact factor: 20.096
Authors: Pranav Sharma; Rosa Djajadiningrat; Kamran Zargar-Shoshtari; Mario Catanzaro; Yao Zhu; Nicola Nicolai; Simon Horenblas; Philippe E Spiess Journal: Urol Oncol Date: 2015-06-10 Impact factor: 3.498
Authors: Kamran Zargar-Shoshtari; Pranav Sharma; Rosa Djajadiningrat; Mario Catanzaro; Ding-Wei Ye; Yao Zhu; Nicola Nicolai; Simon Horenblas; Philippe E Spiess Journal: World J Urol Date: 2015-05-31 Impact factor: 4.226
Authors: Chris Protzel; Antonio Alcaraz; Simon Horenblas; Giorgio Pizzocaro; Alexandre Zlotta; Oliver W Hakenberg Journal: Eur Urol Date: 2009-02-23 Impact factor: 20.096