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• W2605321585 abstract "You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2017PD49-05 PATHOLOGICAL NODAL INVOLVEMENT IN PATIENTS WITH PENILE CANCER IN THE NATIONAL CANCER DATA BASE (NCDB) USING THE UPDATED AJCC STAGING GUIDELINES FOR T2 AND T3 DISEASE James Kearns, Brian Winters, Daniel Lin, and Jonathan Wright James KearnsJames Kearns More articles by this author , Brian WintersBrian Winters More articles by this author , Daniel LinDaniel Lin More articles by this author , and Jonathan WrightJonathan Wright More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2229AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The AJCC recently proposed new TNM staging for penile cancer, splitting the orginal T2 group (tumor invading corpus spongiosum or cavernosum) into T2 (invading corpus spongiosum) and T3 (invading corpus cavernosum). We sought to validate the new T staging system for predicting pathologic nodal involvement using the National Cancer Data Base (NCDB). METHODS Invasive penile cancer cases from 2010-2012 were identified from the NCDB. Pathologic tumor stage was recorded including spongiosal versus carvernosal involvement. Differences in demographic (age, race, comorbid status) and pathologic features (size of tumor, grade, nodal status, LVI, histology, and extranodal extension) between T2 and T3 tumors were compared using χ2 and t-tests. Univariate and multivariate logistic regression was performed to determine the odds of positive lymph nodes (pN+) at inguinal lymph node dissection (ILND) relative to T-stage. RESULTS There were 367 T2 and 507 T3 patients with penile cancer. The proportion of cases with pN+ disease was 15%, 32%, 46% and 58% for T1, T2, T3 and T4 cases, respectively. Compared to T2 tumors, T3 tumors were larger (mean size 5.8 cm vs. 4.3 cm), more often treated with radical penectomy (36% vs 17%), had higher positive surgical margin rates (12% vs 9%), more aggressive pathology (32% vs 27% poorly differentiated), and were more likely to have lymphovascular invasion (42% vs 31%) (all p < 0.05). In univariate analysis, compared to T1 tumors, T2 (OR 2.8, 95% CI 1.9-4.2) and T3 (OR 4.7, 95% CI 3.3-6.8) were both associated with an increased risk of positive lymph nodes. Although in multivariate analysis, both T2 (OR 2.0, 95% CI 1.2-3.3) and T3 (OR 2.3, 95% CI 1.4-3.6) remained significantly associated with risk of positive lymph nodes compared to T1 disease, there was no increase in risk between T2 and T3 disease (OR 1.1, 95% CI 0.7-1.8, p = 0.56). CONCLUSIONS The proposed new AJCC staging system for the penile cancer distinguishes spongiosal (T2) from cavernosal (T3) involvement and identifies significant differences in pathologic features of the tumors (grade, LVI and size). There does not appear to be a difference in positive lymph node status between the two grades when other clinical and pathological variables are considered. Further study is required to confirm these findings and the prognostic implications of the proposed new staging system. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e975-e976 Advertisement Copyright & Permissions© 2017MetricsAuthor Information James Kearns More articles by this author Brian Winters More articles by this author Daniel Lin More articles by this author Jonathan Wright More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2605321585 title "PD49-05 PATHOLOGICAL NODAL INVOLVEMENT IN PATIENTS WITH PENILE CANCER IN THE NATIONAL CANCER DATA BASE (NCDB) USING THE UPDATED AJCC STAGING GUIDELINES FOR T2 AND T3 DISEASE" @default.
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