Prognostic Factors in Penile Cancer: Should We Avoid Inguinal Lymph Node Staging?
Luís Vale1,2, Bernardo Fernandes3, Vasco Rodrigues4
1Department of Urology, Centro Hospitalar Universitário São João, Porto, Portugal, luismpvale@gmail.com.
Urologia Internationalis
|February 18, 2021
Summary
Late diagnosis of penile cancer (PC) significantly impacts survival. Nodal invasion and perineural invasion are key poor prognostic factors, underscoring the need for aggressive surgical treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Urology
Background:
- Penile cancer (PC) is a rare malignancy, predominantly affecting developed nations.
- Early evaluation of prognostic factors in surgically treated PC patients is crucial.
Purpose of the Study:
- To identify and evaluate the primary prognostic factors influencing overall survival in patients with penile cancer undergoing surgical intervention.
- To assess the impact of advanced disease stages and lymph node status on patient outcomes.
Main Methods:
- Retrospective analysis of 65 penile cancer patients treated between 2004 and 2018 at a tertiary referral center.
- Evaluation of overall survival and correlation with prognostic factors including nodal staging and perineural invasion.
Main Results:
- Nearly half of patients (48%) presented with advanced local disease (pT3/4).
- Nodal staging (pN) and perineural invasion were identified as significant predictors of poor prognosis in multivariate analysis.
- Lymph node metastasis and perineural invasion increased the risk of death by 29 and 13 times, respectively.
Conclusions:
- Late diagnosis of penile cancer negatively affects overall survival, with nodal invasion being a critical factor.
- Despite a high rate of negative lymphadenectomies, aggressive surgical management is recommended due to the poor prognosis associated with lymph node metastasis.
