Comparison of the clinical outcomes of laparoscopic and open inguinal lymph node dissection in the treatment of penile cancer
10.3781/j.issn.1000-7431.2023.2204-0222
- VernacularTitle:腹腔镜与开放下腹股沟淋巴结清扫术在阴茎癌治疗中的临床疗效比较
- Author:
Kangli DENG
1
,
2
;
Diansheng CUI
;
Zhuo WEI
;
Yongbo SONG
;
Quan'an JIA
;
Sanhe LIU
;
Lei HUANG
;
Shaozhong WEI
Author Information
1. 华中科技大学同济医学院附属湖北省肿瘤医院泌尿外科,湖北 武汉 430079
2. 湖北省孝感市中心医院泌尿外科,湖北 孝感 432100
- Keywords:
Penile cancer;
Inguinal lymphadenectomy;
Laparoscope surgery;
Overall survival;
Prognosis
- From:
Tumor
2023;43(1):16-28
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of laparoscopic inguinal lymph node dissection(L-ILND)and open inguinal lymph node dissection(O-lLND)in the treatment of penile cancer after radical penile cancer surgery. Methods:The clinical outcomes of 63 patients who were diagnosed with penile cancer(TNM staging:T1_3,N0-3,M0)and received L-ILND(41 cases)or O-ILND(22 cases)after radical penile cancer surgery in Department of Urology,Hubei Cancer Hospital,Tongji Medical College,Huazhong University of Science and Technology from 2008 to 2020 were retrospectively studied.The primary endpoint of this study was overall survival,and the secondary endpoints were 5-year overall survival and 5-year cancer-specific survival.The different clinical characteristics were compared between the L-ILND group and O-ILND group.Univariate and multivariate logistic regression analysis was used to study the risk facotrs for postoperative wound complications.Kaplan-Meier method was used for prognosis analysis.COX regression analysis was used to investigate the factors for overall survival prediction. Results:Among the 63 penile cancer patients studied,41 patients received L-ILND and the remaining 22 received O-ILND.There were no statistically significant differences in the baseline characteristics between the two groups of patients.The median overall survival(78 months vs 72 months,P=0.844),5-year overall survival rate(74.5％vs 78.3％,P=0.144),5-year cancer-specific survival rate(77.2％vs 71.4％,P=0.228)showed no obvious difference between L-ILND and O-ILND group.The rate of postoperative wound complications in the O-ILND group was significantly higher than that in the L-ILND group(74％vs 15％,P=0.01 2).The result of multivariate COX regression analysis showed that tumor grade[hazard ratio(H-R)=2.774,P=0.021]and lymph node pathological stage(HR=1.482,P=0.024)were significantly correlated with patients'prognosis. Conclusion:The clinical efficacy of L-ILND and O-ILND is similar,but L-ILND has a higher safety profile and lower incidence of postoperative wound complications.Therefore,L-ILND is a more ideal surgical approach for inguinal lymph node dissection after radical penile cancer surgery.
