Universität zu Köln

Bandini, Marco, Albersen, Maarten, Chipollini, Juan ORCID: 0000-0003-2603-0382, Pederzoli, Filippo ORCID: 0000-0003-3873-7465, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ager, Michael, Hakenberg, Oliver W., Heidenreich, Axel, Raggi, Daniele, Catanzaro, Mario, Haidl, Friederike, Mazzone, Elio, Marandino, Laura ORCID: 0000-0001-7120-2505, Briganti, Alberto, Montorsi, Francesco, Azizi, Mounsif, Spiess, Philippe E. and Necchi, Andrea (2020). Optimising the selection of candidates for neoadjuvant chemotherapy amongst patients with node-positive penile squamous cell carcinoma. BJU Int., 125 (6). S. 867 - 876. HOBOKEN: WILEY. ISSN 1464-410X

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Abstract

Objectives To identify predictors of poor overall survival (OS) amongst patients with penile squamous cell carcinoma (pSCC) with clinical inguinal lymphadenopathy (cN+), in order to define the best candidates for neoadjuvant chemotherapy (NAC). Patients and Methods Using an international, multicentre database of 924 patients with pSCC, we identified 334 men who harboured cN+ with available clinical and follow-up data. Lymph node involvement was defined either by the presence of palpable inguinal node disease or by preoperative computed tomography (CT) assessment. Fluorine-18 fluorodeoxyglucose positron-emission tomography (F-18-FDG-PET)/CT scan was performed based on clinical judgment of the treating physician. Regression-tree analysis generated a risk stratification tool for prediction of 24-month overall mortality (OM). Kaplan-Meier explored the OS benefit related to the use of NAC according to the regression-tree-stratified subgroups. Results Overall, 120 (35.9%), 152 (45.5%), and 62 (18.6%) patients harboured cN1, cN2, and cN3 disease. F-18-FDG-PET/CT was performed in 48 (14.4%) patients, and 16 (4.8%) had inguinal and pelvic nodal PET detection. The median OS was 107 months, with a 24-month OS of 66%. At regression-tree analysis (area under the curve = 70%), patients with cN3 and cN2 with PET/CT-detected inguinal and pelvic nodal activity had a higher risk of 24-month OM (>50%). NAC was associated with improved 24-month OS rates (54% vs 33%) only in this subgroup of patients (P = 0.002), which was also confirmed after multivariable adjustment (hazard ratio 0.28, 95% confidence interval 0.13-0.62; P = 0.002). Conclusion Patients with pSCC with cN3 or cN2 and inguinal and pelvic 18F-FDG-PET/CT scan detected disease had higher 24-month OM rates according to our regression-tree model. NAC was associated with improved OS only in these subgroups of patients. Our novel decision model may help to stratify cN+ patients, and identify those who most likely will benefit from NAC prior to radical surgical resection.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bandini, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Albersen, Maarten UNSPECIFIED UNSPECIFIED UNSPECIFIED Chipollini, Juan UNSPECIFIED orcid.org/0000-0003-2603-0382 UNSPECIFIED Pederzoli, Filippo UNSPECIFIED orcid.org/0000-0003-3873-7465 UNSPECIFIED Zhu, Yao UNSPECIFIED UNSPECIFIED UNSPECIFIED Ye, Ding-Wei UNSPECIFIED UNSPECIFIED UNSPECIFIED Ornellas, Antonio A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Watkin, Nick UNSPECIFIED UNSPECIFIED UNSPECIFIED Ager, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hakenberg, Oliver W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Raggi, Daniele UNSPECIFIED UNSPECIFIED UNSPECIFIED Catanzaro, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Haidl, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Mazzone, Elio UNSPECIFIED UNSPECIFIED UNSPECIFIED Marandino, Laura UNSPECIFIED orcid.org/0000-0001-7120-2505 UNSPECIFIED Briganti, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Montorsi, Francesco UNSPECIFIED UNSPECIFIED UNSPECIFIED Azizi, Mounsif UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, Philippe E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Necchi, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-339495
DOI:	10.1111/bju.15054
Journal or Publication Title:	BJU Int.
Volume:	125
Number:	6
Page Range:	S. 867 - 876
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1464-410X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COMBINATION CHEMOTHERAPY; CISPLATIN; CANCER; LYMPHADENECTOMY; 5-FLUOROURACIL; METHOTREXATE; INVOLVEMENT; IFOSFAMIDE; DOCETAXEL; BLEOMYCIN Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33949