NEW ORLEANS, LA USA (UroToday.com) - Dr. Mohammed Haseebuddin and group from Fox Chase Cancer Center presented on the receipt of inguinal lymph node dissection in patients with T2 penile cancer using the National Cancer Database.
Per the NCCN guidelines, inguinal lymph node dissection (ILND) is recommended for patients with intermediate (T1b) or high (any T2 or grade 3) risk disease even in the absence of palpable inguinal nodes. The objective was to assess the temporal trends in utilization of ILND and to determine factors associated with it.
The NCDB was queried for all patients diagnosed with T2 penile cancer between 1998-2011. Of 2 019 patients identified, 34.3% underwent ILND. Rates of ILND did not significantly improve from 1998 to 2011 (34.2% to 40%; p = 0.09). On multivariate analysis, patients with high-grade disease (OR 1.35 [CI 1.1-1.7]) and those treated at academic centers (OR 3.2 [CI 2.2-4.7]) were more likely to receive ILND while patients > 70 years of age (OR 0.41 [CI 0.28-0.60]) were less likely to receive ILND.
In conclusion, less than 35% of patients with T2 penile cancer receive ILND, and the rates have not significantly changed over the last decade. Referral of patients with this uncommon, highly morbid, lethal disease to experienced centers may increase adherence to guideline-recommended care.
Presented and reported by Mohammed Haseebuddin, MD at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Fox Chase Cancer Center, Philadelphia, PA USA