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Multicenter Study
. 2017 Feb;143(2):329-335.
doi: 10.1007/s00432-016-2292-3. Epub 2016 Oct 22.

Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study

Zai-Shang Li  1   2   3 , Chuang-Zhong Deng  1   2   3 , Kai Yao  1   2   3 , Yong Tang  4 , Nan Liu  5 , Peng Chen  6 , Bin Wang  7 , Xiang Li  8 , Xiao-Feng Chen  9 , Hong Liao  10 , Qi-Wu Mi  11 , Yong-Hong Lei  12 , Qi Zhao  2   3   13 , Pei-Zhen Zhao  14 , Xue-Ying Li  2   3   15 , Jie-Ping Chen  1   2   3 , Qiang-Hua Zhou  1   2   3 , Zi-Ke Qin  1   2   3 , Zhuo-Wei Liu  1   2   3 , Yong-Hong Li  1   2   3 , Yun-Lin Ye  1   2   3 , Hua Tu  1   2   3 , Zi-Jun Zou  7 , Xing Bi  6 , Feng Yang  6 , Ying-Ming Xiao  10 , Jing Li  7 , Xiang-Tian Lin  16 , Wei-Cong Liang  16 , Hui Han  17   18   19 , Fang-Jian Zhou  20   21   22
Affiliations
Multicenter Study

Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study

Zai-Shang Li et al. J Cancer Res Clin Oncol. 2017 Feb.

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.

Keywords: Lymph node excision; Mortality; Neoplasm metastasis; Penile neoplasms.

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Conflict of interest statement

All of the authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of the study population. PLND pelvic lymphadenectomy; PSCC penile squamous cell carcinoma
Fig. 2
Fig. 2
Kaplan–Meier curve for DSS between the PLND and no-PLND groups. a All study patients; b patients selected in the propensity model; c pN2 patients selected in the propensity model; d pN3 patients selected in the propensity model
See this image and copyright information in PMC

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