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Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study

Journal of Cancer Research and Clinical Oncology volume 143, pages 329–335 (2017)Cite this article

Abstract

Background

Current guidelines recommend pelvic lymphadenectomy (PLND) for patients with pelvic lymph node metastasis and special state. However, these data and recommendations do not distinguish the role of PLND in different patient groups and confirm the final benefits. The aim of this study was to confirm the efficacy of pelvic lymphadenectomy (PLND) for the different groups of patients.

Methods

Data obtained from 7 centers were retrospectively analyzed. Of the patients, 190 pN2-3 penile carcinoma patients confirmed by bilateral inguinal lymph node excision were included in this study. Sixty-nine and 121 of these patients did and did not undergo bilateral PLND, respectively. The baseline differences from the patients were matched by propensity score analysis.

Results

In this study, the Kaplan–Meier estimated disease-specific survival (DSS) was not significantly different between the PLND and no-PLND groups (P = 0.796). According to the propensity score matching for T stage, N stage, grade, adjuvant therapies, and lymph node stage (number of inguinal lymph node metastasis and extranodal extension), 48 patients were selected for each group. Among the pN2 patients, the PLND group showed higher DSS rates than the no-surgery group (P = 0.030). However, even after matching, survival did not differ between the PLND and no-PLND patients among all patients (P = 0.609) and pN3 patients (P = 0.417) with comparable DSS.

Conclusion

Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.

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Fig. 1
Fig. 2

Abbreviations

DSS:

Disease-specific survival

ENE:

Extranodal extension

LNM:

Lymph node metastasis

PLND:

Pelvic lymphadenectomy

PSCC:

Penile squamous cell carcinoma

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Acknowledgments

The authors are grateful to the enrolled patients, their families, and the referring physicians. We also gratefully acknowledge the contribution of all colleagues in this study. And we thank our families for supporting us.

Funding

The study is supported by grants from the Planned Science and Technology Project of Guangdong Province, China (2015A030302018), Sun Yat-sen University Cancer Center and State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.

Author’s contribution

HH and FJ Z had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

ZS L, DC Z, HH, and FJ Z conceived and designed the study, developed, analyzed, and interpreted the flow cytometry studies, drafted the manuscript; ZS L, DC Z, HH, FJ Z, QZ, and PZ Z analysed data acquisition and interpretation. All authors provided clinical information and reviewed the manuscript; QZ and PZ Z performed data acquisition and analysis; HH and FJ Z participated in revising the manuscript. All authors read and approved the final manuscript.

Author information

Author notes

    Affiliations

    1. Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China

      Zai-Shang Li, Chuang-Zhong Deng, Kai Yao, Jie-Ping Chen, Qiang-Hua Zhou, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Yun-Lin Ye, Hua Tu, Hui Han & Fang-Jian Zhou

    2. State Key Laboratory of Oncology in Southern China, Guangzhou, People’s Republic of China

      Zai-Shang Li, Chuang-Zhong Deng, Kai Yao, Qi Zhao, Xue-Ying Li, Jie-Ping Chen, Qiang-Hua Zhou, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Yun-Lin Ye, Hua Tu, Hui Han & Fang-Jian Zhou

    3. Collaborative Innovation Center of Cancer Medicine, Guangzhou, People’s Republic of China

      Zai-Shang Li, Chuang-Zhong Deng, Kai Yao, Qi Zhao, Xue-Ying Li, Jie-Ping Chen, Qiang-Hua Zhou, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Yun-Lin Ye, Hua Tu, Hui Han & Fang-Jian Zhou

    4. Department of Urology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, People’s Republic of China

      Yong Tang

    5. Department of Urology Oncological Surgery, Chongqing Cancer Hospital and Institute and Cancer Center, Chongqing, China

      Nan Liu

    6. Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümchi, People’s Republic of China

      Peng Chen, Xing Bi & Feng Yang

    7. Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, People’s Republic of China

      Bin Wang, Zi-Jun Zou & Jing Li

    8. Department of Urology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China

      Xiang Li

    9. Department of Urology, The First People’s Hospital of Chenzhou, Chenzhou, People’s Republic of China

      Xiao-Feng Chen

    10. Department of Urology, Sichuan Cancer Hospital, Chengdu, People’s Republic of China

      Hong Liao & Ying-Ming Xiao

    11. Department of Urology, Dong Guan People’s Hospital, Dongguan, People’s Republic of China

      Qi-Wu Mi

    12. Department of Urology, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People’s Republic of China

      Yong-Hong Lei

    13. School of Life Science, Sun Yat-Sen UniversitySchool of Life Science, Guangzhou, People’s Republic of China

      Qi Zhao

    14. Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, People’s Republic of China

      Pei-Zhen Zhao

    15. Department of Medical Oncology, Cancer Center of Sun Yat-Sen University, Guangzhou, People’s Republic of China

      Xue-Ying Li

    16. Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People’s Republic of China

      Xiang-Tian Lin & Wei-Cong Liang

    Authors
    1. Zai-Shang Li
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    Corresponding authors

    Correspondence to Hui Han or Fang-Jian Zhou.

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    All of the authors declare that they have no conflict of interest.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Additional information

    Zai-Shang Li and Chuang-Zhong Deng have contributed equally to this research.

    The optimal surgical resection strategies for different level of penile cancer patient groups.

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    Li, ZS., Deng, CZ., Yao, K. et al. Bilateral pelvic lymph node dissection for Chinese patients with penile cancer: a multicenter collaboration study. J Cancer Res Clin Oncol 143, 329–335 (2017). https://doi.org/10.1007/s00432-016-2292-3

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    Keywords

    • Penile neoplasms
    • Lymph node excision
    • Neoplasm metastasis
    • Mortality