Universität zu Köln

Chakiryan, Nicholas H., Dahmen, Aaron, Bandini, Marco, Pederzoli, Filippo ORCID: 0000-0003-3873-7465, Marandino, Laura ORCID: 0000-0001-7120-2505, Albersen, Maarten, Roussel, Eduard ORCID: 0000-0002-7835-5536, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Catanzaro, Mario, Hakenberg, Oliver W., Heidenreich, Axel, Haidl, Friederike, Watkin, Nick, Ager, Michael, Briganti, Alberto, Salvioni, Roberto, Montorsi, Francesco, Necchi, Andrea and Spiess, Philippe E. (2021). Risk factors and survival outcomes for upstaging after inguinal lymph node dissection for cN1 penile squamous cell carcinoma. Urol. Oncol.-Semin. Orig. Investig., 39 (12). NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-2496

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Abstract

Objectives: To identify incidence and risk factors for upstaging from cN1 to pN2/N3 at inguinal lymphadenectomy (ILND) for penile cancer (pSCC). Our secondary objective is to assess survival outcomes and associations for cN1 patients undergoing ILND. Subjects/patients and methods: Patients with pT >= 1cN1cM0 pSCC who underwent bilateral ILND and had complete data were identified in a multi-institutional international cohort from 8 referral centers in 7 countries diagnosed from 1980 to 2017. Upstaging was defined as pN2/N3 at ILND. Multivariable logistic regression analysis was used to determine associations with upstaging, and Cox multivariable logistic regression analysis to determine associations with overall survival (OS). Results: Of 144 patients were included in the final study population. 84 patients (58%) were upstaged from cN1 to pN2/N3, and 25 (17%) were down staged to pN0. Upstaging was associated with pT3/T4 (OR 4.1, 95%CI 1.5-11.7, P < 0.01) and pTX (OR 7.1, 95CI 1.6 -51.1, P= 0.02). Age, smoking status, HPV status, and LVI were not associated with upstaging. Age (HR 1.03/y, 95%CI 1.01-1.06, P < 0.01) and upstaging (HR 2.8, 95%CI 1.3-5.9, P < 0.01) were associated with worse OS. Upstaged patients had a 5-year OS of 49%, compared with 86% for patients who were not upstaged. Conclusion: The majority of cN1 pSCC patients harbor a higher-risk disease state than their clinical staging suggests, especially those with higher pT stages. More intensive pre-operative workup may be warranted for these patients to identify upstaging prior to ILND and potentially qualify them for neoadjuvant chemotherapy or clinical trials. (C) 2021 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Chakiryan, Nicholas H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dahmen, Aaron UNSPECIFIED UNSPECIFIED UNSPECIFIED Bandini, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Pederzoli, Filippo UNSPECIFIED orcid.org/0000-0003-3873-7465 UNSPECIFIED Marandino, Laura UNSPECIFIED orcid.org/0000-0001-7120-2505 UNSPECIFIED Albersen, Maarten UNSPECIFIED UNSPECIFIED UNSPECIFIED Roussel, Eduard UNSPECIFIED orcid.org/0000-0002-7835-5536 UNSPECIFIED Zhu, Yao UNSPECIFIED UNSPECIFIED UNSPECIFIED Ye, Ding-Wei UNSPECIFIED UNSPECIFIED UNSPECIFIED Ornellas, Antonio A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Catanzaro, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Hakenberg, Oliver W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Haidl, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Watkin, Nick UNSPECIFIED UNSPECIFIED UNSPECIFIED Ager, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Briganti, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Salvioni, Roberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Montorsi, Francesco UNSPECIFIED UNSPECIFIED UNSPECIFIED Necchi, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, Philippe E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-601437
DOI:	10.1016/j.urolonc.2021.08.028
Journal or Publication Title:	Urol. Oncol.-Semin. Orig. Investig.
Volume:	39
Number:	12
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1873-2496
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROGNOSTIC-FACTORS; NEGATIVE PATIENTS; CANCER; CHEMOTHERAPY; METASTASIS; INVOLVEMENT; EXTENT Multiple languages Oncology; Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60143