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• W2005243004 abstract "No AccessJournal of UrologyAdult Urology1 Oct 2010Prognostic Significance of Extranodal Extension in Patients With Pathological Node Positive Penile Carcinoma Niels M. Graafland, Hester H. van Boven, Erik van Werkhoven, Luc M.F. Moonen, and Simon Horenblas Niels M. GraaflandNiels M. Graafland Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author , Hester H. van BovenHester H. van Boven Department of Pathology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author , Erik van WerkhovenErik van Werkhoven Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author , Luc M.F. MoonenLuc M.F. Moonen Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author , and Simon HorenblasSimon Horenblas Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.06.016AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the prognostic significance of extranodal extension, defined as tumor extension through the lymph node capsule into the perinodal fibrous-adipose tissue, as well as several other risk factors in node positive penile cancer cases. Materials and Methods: We analyzed prospectively collected data on a consecutive series of 156 chemotherapy naïve patients with proven lymph node involvement who underwent therapeutic regional lymphadenectomy. Postoperative external radiotherapy was indicated when histopathological analysis revealed more tumor than 1 intranodal metastasis. We estimated cancer specific survival using the Kaplan-Meier method. Multivariate analysis was done according to the Cox proportional hazards model of factors statistically significant on univariate analysis. Results: Adjuvant radiotherapy was done in 70 patients (45%). Median followup was 57.8 months. Overall 5-year cancer specific survival was 61%. Men with extranodal extension had significantly decreased 5-year cancer specific survival compared with men without it (42% vs 80%). Other prognostic variables on univariate analysis were bilateral metastatic involvement vs unilateral, 3 or greater unilateral metastatic inguinal nodes vs 2 or fewer, inguinal lymphadenectomy positive margin status vs negative status and pelvic lymph node involvement. Pathological T stage or differentiation grade were not significant predictors of outcome. On multivariate analysis extranodal extension and pelvic lymph node involvement remained associated with decreased cancer specific survival (HR 2.37 and 2.20, respectively). Conclusions: Metastatic inguinal lymph node extranodal extension and pelvic lymph node involvement are independent predictive parameters of cancer specific survival in patients with pathologically node positive penile carcinoma despite surgery with postoperative radiotherapy. References 1 : Penile cancer: relation of extent of nodal metastasis to survival. J Urol1987; 137: 880. 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Google Scholar © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAzizi M, Aydin A, Hajiran A, Lai A, Kumar A, Peyton C, Minhas S, Sonpavde G, Chahoud J, Pagliaro L, Necchi A and Spiess P (2020) Systematic Review and Meta-Analysis—Is there a Benefit in Using Neoadjuvant Systemic Chemotherapy for Locally Advanced Penile Squamous Cell Carcinoma?Journal of Urology, VOL. 203, NO. 6, (1147-1155), Online publication date: 1-Jun-2020.O'Brien J, Perera M, Manning T, Bozin M, Cabarkapa S, Chen E and Lawrentschuk N (2017) Penile Cancer: Contemporary Lymph Node ManagementJournal of Urology, VOL. 197, NO. 6, (1387-1395), Online publication date: 1-Jun-2017.Zargar-Shoshtari K, Djajadiningrat R, Sharma P, Catanzaro M, Zhu Y, Nicolai N, Horenblas S and Spiess P (2015) Establishing Criteria for Bilateral Pelvic Lymph Node Dissection in the Management of Penile Cancer: Lessons Learned from an International Multicenter CollaborationJournal of Urology, VOL. 194, NO. 3, (696-702), Online publication date: 1-Sep-2015.Djajadiningrat R, van Werkhoven E and Horenblas S (2014) Prophylactic Pelvic Lymph Node Dissection in Patients with Penile CancerJournal of Urology, VOL. 193, NO. 6, (1976-1980), Online publication date: 1-Jun-2015.Djajadiningrat R, van Werkhoven E, Meinhardt W, van Rhijn B, Bex A, van der Poel H and Horenblas S (2013) Penile Sparing Surgery for Penile Cancer—Does it Affect Survival?Journal of Urology, VOL. 192, NO. 1, (120-126), Online publication date: 1-Jul-2014.Longpre M, Lange P, Kwon J and Black P (2012) Penile Carcinoma: Lessons Learned from Vulvar CarcinomaJournal of Urology, VOL. 189, NO. 1, (17-24), Online publication date: 1-Jan-2013.Zhu Y, Ye D, Yao X, Zhang S, Dai B and Zhang H (2011) New N Staging System of Penile Cancer Provides a Better Reflection of PrognosisJournal of Urology, VOL. 186, NO. 2, (518-523), Online publication date: 1-Aug-2011.Graafland N, Moonen L, van Boven H, van Werkhoven E, Kerst J and Horenblas S (2011) Inguinal Recurrence Following Therapeutic Lymphadenectomy for Node Positive Penile Carcinoma: Outcome and Implications for ManagementJournal of Urology, VOL. 185, NO. 3, (888-894), Online publication date: 1-Mar-2011.Graafland N, Teertstra H, Besnard A, van Boven H and Horenblas S (2011) Identification of High Risk Pathological Node Positive Penile Carcinoma: Value of Preoperative Computerized Tomography ImagingJournal of Urology, VOL. 185, NO. 3, (881-887), Online publication date: 1-Mar-2011. Volume 184Issue 4October 2010Page: 1347-1353 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordslymph node dissectioncarcinomapenile neoplasmsneoplasm metastasispenisMetricsAuthor Information Niels M. Graafland Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author Hester H. van Boven Department of Pathology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author Erik van Werkhoven Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author Luc M.F. Moonen Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author Simon Horenblas Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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