Concomitant vs Staged Therapeutic Inguinal Lymphadenectomy in Clinically Node Positive Penile Squamous Cell Carcinoma: Does It Make a Difference?

No AccessJournal of UrologyAdult Urology1 Mar 2023Concomitant vs Staged Therapeutic Inguinal Lymphadenectomy in Clinically Node Positive Penile Squamous Cell Carcinoma: Does It Make a Difference? Heather L. Huelster, Andrew Chang, Kyle M. Rose, Marco Bandini, Maarten Albersen, Eduard Roussel, Juan Chipollini, Yao Zhu, Ding-Wei Ye, Antonio A. Ornellas, Mario Catanzaro, Laura Marandino, Filippo Pederzoli, Oliver W. Hakenberg, Axel Heidenreich, Friederike Haidl, Nick Watkin, Michael Ager, Mohamed E. Ahmed, Jeffrey R. Karnes, Alberto Briganti, Youngchul Kim, Francesco Montorsi, Andrea Necchi, and Philippe E. Spiess Heather L. HuelsterHeather L. Huelster *Correspondence: Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL 33612 telephone: 888-663-3488; E-mail Address: [email protected] https://orcid.org/0000-0001-5411-3148 H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author , Andrew ChangAndrew Chang H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author , Kyle M. RoseKyle M. Rose H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author , Marco BandiniMarco Bandini Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author , Maarten AlbersenMaarten Albersen University Hospitals Leuven, Leuven, Belgium More articles by this author , Eduard RousselEduard Roussel University Hospitals Leuven, Leuven, Belgium More articles by this author , Juan ChipolliniJuan Chipollini H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author , Yao ZhuYao Zhu Fudan University Shanghai Cancer Center, Shanghai, China More articles by this author , Ding-Wei YeDing-Wei Ye Fudan University Shanghai Cancer Center, Shanghai, China More articles by this author , Antonio A. OrnellasAntonio A. Ornellas Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil More articles by this author , Mario CatanzaroMario Catanzaro Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy More articles by this author , Laura MarandinoLaura Marandino Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy More articles by this author , Filippo PederzoliFilippo Pederzoli Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York More articles by this author , Oliver W. HakenbergOliver W. Hakenberg University Hospital Rostock, Rostock, Germany More articles by this author , Axel HeidenreichAxel Heidenreich Universitätsklinikum Köln, Köln, Germany More articles by this author , Friederike HaidlFriederike Haidl Universitätsklinikum Köln, Köln, Germany More articles by this author , Nick WatkinNick Watkin St George's University Hospitals, NHS Foundation Trust, London, United Kingdom More articles by this author , Michael AgerMichael Ager St George's University Hospitals, NHS Foundation Trust, London, United Kingdom More articles by this author , Mohamed E. AhmedMohamed E. Ahmed Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Jeffrey R. KarnesJeffrey R. Karnes Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Alberto BrigantiAlberto Briganti Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author , Youngchul KimYoungchul Kim H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author , Francesco MontorsiFrancesco Montorsi Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author , Andrea NecchiAndrea Necchi Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author , and Philippe E. SpiessPhilippe E. Spiess H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003099AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Inguinal lymph node dissection within 3 months of primary tumor resection in penile cancer has been associated with longer recurrence-free and cancer-specific survival. However, the optimal timing and effect of lymphadenectomy performed concurrently at the time of primary lesion management on oncologic outcomes in clinically lymph node positive penile squamous cell carcinoma remains unknown. Materials and Methods: An international, multicenter cohort of 966 penile cancer cases was queried for penile squamous cell carcinoma management after the year 2000, clinically lymph node positive status, and performance of penile surgery and inguinal lymph node dissection. Cohorts were stratified as concomitant if inguinal lymph node dissection and penile surgery occurred on the same date or staged when inguinal lymph node dissection was performed after penile resection. Rates and patterns of penile squamous cell carcinoma recurrence were reported. Distant recurrence-free, cancer-specific, and overall survival were estimated using Kaplan-Meier analyses and groups compared with log-rank testing. Results: Of 253 contemporary men with clinically lymph node positive penile squamous cell carcinoma, 96 (38%) underwent concomitant inguinal lymph node dissection and 157 (62%) had inguinal lymph node dissection performed in a staged manner. Penile cancer was most likely to recur distantly (19%) followed by in the groin (14%) or pelvis (5%). There were no differences in distant recurrence-free, cancer-specific, or overall survival between management strategies. Multivariable analysis adjusting for stage, treatment center, and perioperative chemoradiation also demonstrated no recurrence-free, cancer-specific, or overall survival benefit between management strategies. Conclusions: Inguinal lymph node dissection performed concurrently with excision of the penile tumor for clinically node positive penile squamous cell carcinoma is not associated with differences in recurrence-free, cancer-specific, or overall survival compared to staged lymph node dissection. References 1. . Prognostic factors in penile cancer. Urology. 2010; 76(2):S66-S73. Crossref, Medline, Google Scholar 2. . Patterns of recurrence following inguinal lymph node dissection for penile cancer: optimizing surveillance strategies. J Urol. 2021; 206(4):960-969. Link, Google Scholar 3. National Comprehensive Cancer Network. Penile Cancer, version 2. 2022. Accessed November 11, 2022. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1456. Google Scholar 4. 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Presented at annual meeting of American Urological Association, New Orleans, Louisiana, May 13-16, 2022. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue 3March 2023Page: 557-564Supplementary Materials Peer Review Report Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Keywordslymph node excisiontreatment outcomepenile neoplasmsneoadjuvant therapycarcinoma, squamous cellAcknowledgmentsWe thank all of the study managers, staff, and chart abstractors through the Global Society of Rare Genitourinary Tumors for their efforts in data collection to support this study.MetricsAuthor Information Heather L. Huelster H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida *Correspondence: Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Dr, Tampa, FL 33612 telephone: 888-663-3488; E-mail Address: [email protected] More articles by this author Andrew Chang H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author Kyle M. Rose H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author Marco Bandini Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author Maarten Albersen University Hospitals Leuven, Leuven, Belgium More articles by this author Eduard Roussel University Hospitals Leuven, Leuven, Belgium More articles by this author Juan Chipollini H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author Yao Zhu Fudan University Shanghai Cancer Center, Shanghai, China More articles by this author Ding-Wei Ye Fudan University Shanghai Cancer Center, Shanghai, China More articles by this author Antonio A. Ornellas Hospital Mário Kröeff and Brazilian Cancer Institute, Rio de Janeiro, Brazil More articles by this author Mario Catanzaro Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy More articles by this author Laura Marandino Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy More articles by this author Filippo Pederzoli Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York More articles by this author Oliver W. Hakenberg University Hospital Rostock, Rostock, Germany More articles by this author Axel Heidenreich Universitätsklinikum Köln, Köln, Germany More articles by this author Friederike Haidl Universitätsklinikum Köln, Köln, Germany More articles by this author Nick Watkin St George's University Hospitals, NHS Foundation Trust, London, United Kingdom More articles by this author Michael Ager St George's University Hospitals, NHS Foundation Trust, London, United Kingdom More articles by this author Mohamed E. Ahmed Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Jeffrey R. Karnes Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Alberto Briganti Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author Youngchul Kim H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author Francesco Montorsi Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author Andrea Necchi Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy More articles by this author Philippe E. Spiess H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida More articles by this author Expand All Support: Data collection was supported by the Global Society of Rare Genitourinary Tumors. Conflict of Interest: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. 16229). Presented at annual meeting of American Urological Association, New Orleans, Louisiana, May 13-16, 2022. Advertisement PDF downloadLoading ...