Risk factors predicting inguinal node metastasis in squamous cell cancer of penis
10.3760/cma.j.issn.1000-6702.2011.04.017
- VernacularTitle:阴茎鳞状细胞癌腹股沟淋巴结转移的危险因素分析
- Author:
Keshi LU
;
Mingkun CHEN
;
Fangjian ZHOU
;
Hui HAN
;
Zhuowei LIU
;
Yonghong LI
;
Kai YAO
;
Jianye LIU
;
Zike QIN
- Publication Type:Journal Article
- Keywords:
Penile neoplasms;
Carcinoma,squamous cell;
Inguinal metastasis;
Risk factors;
Survival analysis
- From:
Chinese Journal of Urology
2011;32(4):273-277
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the risk factors of inguinal metastasis in squamous cell carcinoma of the penis, screening lymph node metastasis high-risk patients. Methods The clinical and pathological data of 81 consecutive patients with squamous cell carcinoma of the penis were analyzed retrospectively. Age at presentation ranged from 27 to 81 years with a median of 49 years. Course of disease within one year of patients with 46 cases (56.8%), 1 year above 35 eases (43.2 %). Seventyfive patients underwent bilateral inguinal lymph node dissection, and 6 patients had unilateral inguinal lymph node dissection. Clinical stage of the primary tumor was assigned according to the 2002 TNM staging system. Variables included patients' age, redundant prepuce and/or phimosis, tumor site,size, number, macroscopic growth pattern, histological grade, inguinal physical examination and the size of inguinal lymph nodes. Results Of the 81 patients, 42 (51.9%) were staged as pN+ and 39 (48. 1%) as pN0. Metastases occurred in 32.0% (16/50) of G1, 78.3% (18/23) of G2 and 100. 0%(8/8) of G3 cases, with significant differences among them (P= 0. 015). According to the inguinal lymph node physical examination results, 63 were staged as clinically node-positive (cN+) and 18 as clinically node-negative (cN0). Metastases occurred in 63. 5% (40/63) of cases of cN+, as compared with 11.1% (2/18) of cases of cN0(P=0. 012). At a median follow up of 40 months (ranged 2-127 months), the 5-year disease free survival rates for positive and negative inguinal lymph nodes metastasis were 71.4% and 92.3%, respectively (P=0. 005) , and the 5-year cancer specific survival rates were 79.0% and 91.4%, respectively (P=0.001). Conclusions Inguinal physical examination and histological grade were the strongest predictors of inguinal metastasis. The patients with inguinal lymph nodes metastasis have lower 5-year disease free survival rates and cancer specific survival rates,and should receive positive treatment measures.
