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Erschienen in: World Journal of Urology 1/2010

01.02.2010 | Original Article

Factors predicting inguinal node metastasis in squamous cell cancer of penis

verfasst von: Suresh K. Bhagat, Ganesh Gopalakrishnan, Nitin S. Kekre, Ninan K. Chacko, Santosh Kumar, M. T. Manipadam, Prasanna Samuel

Erschienen in: World Journal of Urology | Ausgabe 1/2010

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Abstract

Purpose

To identify factors predicting the risk of inguinal metastasis in squamous cell carcinoma of the penis. The therapeutic advantages of early lymphadenectomy in squamous cell carcinoma of the penis must be counterbalanced against its post-operative morbidity. Loss to follow up is a major problem in developing countries. Generating a nomogram based on clinical lymph node status and histopathological findings in the primary tumor could facilitate clinical decision making in the management of penile cancer.

Methods

We prospectively studied 106 patients with penile squamous cell cancer treated from September 2001 to August 2007 at our institution. All patients were offered lymphadenectomy (LAD). A multivariate logistic regression model was used to develop a nomogram. We highlight the problems of loss to follow up in these patients.

Results

Of 53 who opted for LAD, 22 had nodal metastasis. The presence of high grade (P = 0.004), lymphovascular invasion (LVI) (P = 0.01) and palpable inguinal lymph nodes (P = 0.05) were the strongest predictors of metastasis. Of 51 who refused LAD, 22 were lost to follow up. Out of these, 16 were at high risk and 9 of them came back with inoperable fungating nodes. A nomogram predicting the risk of lymph node metastasis showed a bias corrected good concordance index (0.74) and good calibration.

Conclusions

High grade and LVI in the tumor along with clinical stage of the inguinal nodes were the strongest predictors of metastasis. These features helped us to develop a nomogram to predict and to identify patients at risk of nodal metastasis.
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Metadaten
Titel
Factors predicting inguinal node metastasis in squamous cell cancer of penis
verfasst von
Suresh K. Bhagat
Ganesh Gopalakrishnan
Nitin S. Kekre
Ninan K. Chacko
Santosh Kumar
M. T. Manipadam
Prasanna Samuel
Publikationsdatum
01.02.2010
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 1/2010
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-009-0421-1

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