Mp61-09 Potential Survival Benefits of Lymph Node Dissection in Lymph Node Negative Penile Squamous Cell Carcinoma Patients: A Focus on T2+n0m0 Stage

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You have accessJournal of UrologyPenile & Testicular Cancer II (MP61)1 May 2024MP61-09 POTENTIAL SURVIVAL BENEFITS OF LYMPH NODE DISSECTION IN LYMPH NODE NEGATIVE PENILE SQUAMOUS CELL CARCINOMA PATIENTS: A FOCUS ON T2+N0M0 STAGE Hangcheng Fu and Murali Ankem Hangcheng FuHangcheng Fu and Murali AnkemMurali Ankem View All Author Informationhttps://doi.org/10.1097/01.JU.0001009536.58867.87.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Penile squamous cell carcinoma (PSCC) although rare, poses a significant health challenge due to its potential for serious morbidity. Current clinical guidelines do not typically recommend lymph node dissection in penile cancer patients who are clinically lymph node-negative, primarily due to the invasive nature of the procedure and the potential for postoperative complications. However, the potential benefits of lymph node dissection in this patient population remain unexplored. No study to date has investigated whether lymph node dissection could offer survival benefits in this specific cohort, leaving a significant gap in our understanding of optimal therapeutic strategies for these patients. METHODS: This study utilized the Surveillance, Epidemiology, and End Results (SEER) database and included 833 patients diagnosed with T2+N0M0 stage penile squamous cell carcinoma between 2004 and 2015 were selected from 3556 penile cancer patients. Inclusion criteria consisted of histological confirmation with the primary site of cancer being the penis and histology diagnosis consistent with squamous cell carcinoma. Exclusion criteria consisted for non-available AJCC stage and unknown follow-up times. Chi square analysis, Kaplan-Meier survival analysis and Multivariable Cox regression were used to perform statistical analysis. The median follow-up time is 58 months. RESULTS: Our study cohort predominantly comprised Non-Hispanic White (65.2%) and Hispanic (22.3%) patients diagnosed with Penile Squamous Cell Carcinoma (PSCC). The median age at diagnosis was 69 years. The majority of these patients were married (57.2%), and only a small proportion received radiation (6.6%) or chemotherapy (3.5%). Despite 23.5% of patients undergoing lymph node dissection, there was no statistical difference in the proportion of dissections across different AJCC T stages. Interestingly, the likelihood of receiving chemotherapy increased with the disease stage (2.4% in T2, 4.5% in T3, and 11.4% in T4; p=0.009). However, the receipt of radiation did not significantly differ across T stages. Kaplan-Meier survival analysis revealed no survival benefit associated with either chemotherapy or radiation. Contrarily, lymph node dissection was significantly associated with disease-specific survival benefits in the overall cohort (p<0.001), T2 stage (p=0.040), and T3 stage (p=0.002). Multivariable Cox analysis further underscored lymph node dissection as an independent protective prognostic factor (HR=0.483, 95% CI 0.328–0.711, p<0.001). CONCLUSIONS: Our analysis suggests a possible survival benefit from regional lymph node dissection in lymph node-negative penile squamous cell carcinoma patients. However, these results, derived from retrospective data, should be interpreted with caution. It is clear that more research is needed. Specifically, well-designed prospective studies are essential to further explore and validate the potential benefits of lymph node dissection in this patient population. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1013 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Hangcheng Fu More articles by this author Murali Ankem More articles by this author Expand All Advertisement PDF downloadLoading ...