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.
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.
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.
Bilateral PLND may improve survival in pN2 patients. Men with pN3 may not benefit from bilateral PLND.
Journal of cancer research and clinical oncology. 2016 Oct 22 [Epub ahead of print]
Zai-Shang Li, Chuang-Zhong Deng, Kai Yao, Yong Tang, Nan Liu, Peng Chen, Bin Wang, Xiang Li, Xiao-Feng Chen, Hong Liao, Qi-Wu Mi, Yong-Hong Lei, Qi Zhao, Pei-Zhen Zhao, Xue-Ying Li, Jie-Ping Chen, Qiang-Hua Zhou, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Yun-Lin Ye, Hua Tu, Zi-Jun Zou, Xing Bi, Feng Yang, Ying-Ming Xiao, Jing Li, Xiang-Tian Lin, Wei-Cong Liang, Hui Han, Fang-Jian Zhou
Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China., Department of Urology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, People's Republic of China., Department of Urology Oncological Surgery, Chongqing Cancer Hospital and Institute and Cancer Center, Chongqing, China., Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Ürümchi, People's Republic of China., Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, People's Republic of China., Department of Urology, West China Hospital of Sichuan University, Chengdu, People's Republic of China., Department of Urology, The First People's Hospital of Chenzhou, Chenzhou, People's Republic of China., Department of Urology, Sichuan Cancer Hospital, Chengdu, People's Republic of China., Department of Urology, Dong Guan People's Hospital, Dongguan, People's Republic of China., Department of Urology, Yunnan Provincial Tumor Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, People's Republic of China., State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China., Guangdong Provincial Center for Skin Disease and STI Control, Guangzhou, People's Republic of China., Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, People's Republic of China., Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. ., Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China. .