Does bilateral inguinal node involvement confer a worse prognosis than unilateral disease in penile cancer?
BAUS ePoster online library. Jae Lee H. 06/21/21; 319085; p4-7
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Hack Jae Lee
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Introduction: The TMN classification for nodal staging in penile squamous carcinoma (SCCp), classifies unilateral disease without extracapsular extension in one or two inguinal nodes as N1 and bilateral disease in one or more nodes as N2. To our knowledge, there is no good quality evidence to confirm this categorisation.
Patients and Methods: Analysis of the prospective dynamic sentinel node (DSNB) database identified all SCCp patients with cN0 node positive disease 2003-2019. Exclusions were N3 disease (to avoid additional confounding factors such as neo/adjuvant therapy and pelvic node involvement), incomplete staging of inguinal basins, non-penile SCC, false negative sentinel node study. All patients were managed by the same MDT and treatment standardised over the period.
Statistical analysis: Kaplan Meier used to calculate 5-year cancer specific survival (CSS) for patients with unilateral and bilateral N1/2 disease. Pearson Chi square used to confirm groups evenly matched for independent prognostic markers (Primary Tumour Grade and LVI)
Results: 899 patients with SCCp underwent DSNB with 189 (21%) positive. After exclusions, 53 had unilateral disease and 11 bilateral with one or two nodes positive. Both groups statistically similar prognostic risk factors. 5-year CSS for unilateral (N1/2) was 86% (95% CI 73% - 93%) and 70% for bilateral (95% CI 32%-89%) with no statistically significant difference (p=0.28).
Conclusions: There is no significant difference in survival between unilateral and bilateral early metastatic disease. Rarity of SCCp precludes a tighter confidence interval and a larger study is required to detect if there is a small significant difference.
Patients and Methods: Analysis of the prospective dynamic sentinel node (DSNB) database identified all SCCp patients with cN0 node positive disease 2003-2019. Exclusions were N3 disease (to avoid additional confounding factors such as neo/adjuvant therapy and pelvic node involvement), incomplete staging of inguinal basins, non-penile SCC, false negative sentinel node study. All patients were managed by the same MDT and treatment standardised over the period.
Statistical analysis: Kaplan Meier used to calculate 5-year cancer specific survival (CSS) for patients with unilateral and bilateral N1/2 disease. Pearson Chi square used to confirm groups evenly matched for independent prognostic markers (Primary Tumour Grade and LVI)
Results: 899 patients with SCCp underwent DSNB with 189 (21%) positive. After exclusions, 53 had unilateral disease and 11 bilateral with one or two nodes positive. Both groups statistically similar prognostic risk factors. 5-year CSS for unilateral (N1/2) was 86% (95% CI 73% - 93%) and 70% for bilateral (95% CI 32%-89%) with no statistically significant difference (p=0.28).
Conclusions: There is no significant difference in survival between unilateral and bilateral early metastatic disease. Rarity of SCCp precludes a tighter confidence interval and a larger study is required to detect if there is a small significant difference.
Introduction: The TMN classification for nodal staging in penile squamous carcinoma (SCCp), classifies unilateral disease without extracapsular extension in one or two inguinal nodes as N1 and bilateral disease in one or more nodes as N2. To our knowledge, there is no good quality evidence to confirm this categorisation.
Patients and Methods: Analysis of the prospective dynamic sentinel node (DSNB) database identified all SCCp patients with cN0 node positive disease 2003-2019. Exclusions were N3 disease (to avoid additional confounding factors such as neo/adjuvant therapy and pelvic node involvement), incomplete staging of inguinal basins, non-penile SCC, false negative sentinel node study. All patients were managed by the same MDT and treatment standardised over the period.
Statistical analysis: Kaplan Meier used to calculate 5-year cancer specific survival (CSS) for patients with unilateral and bilateral N1/2 disease. Pearson Chi square used to confirm groups evenly matched for independent prognostic markers (Primary Tumour Grade and LVI)
Results: 899 patients with SCCp underwent DSNB with 189 (21%) positive. After exclusions, 53 had unilateral disease and 11 bilateral with one or two nodes positive. Both groups statistically similar prognostic risk factors. 5-year CSS for unilateral (N1/2) was 86% (95% CI 73% - 93%) and 70% for bilateral (95% CI 32%-89%) with no statistically significant difference (p=0.28).
Conclusions: There is no significant difference in survival between unilateral and bilateral early metastatic disease. Rarity of SCCp precludes a tighter confidence interval and a larger study is required to detect if there is a small significant difference.
Patients and Methods: Analysis of the prospective dynamic sentinel node (DSNB) database identified all SCCp patients with cN0 node positive disease 2003-2019. Exclusions were N3 disease (to avoid additional confounding factors such as neo/adjuvant therapy and pelvic node involvement), incomplete staging of inguinal basins, non-penile SCC, false negative sentinel node study. All patients were managed by the same MDT and treatment standardised over the period.
Statistical analysis: Kaplan Meier used to calculate 5-year cancer specific survival (CSS) for patients with unilateral and bilateral N1/2 disease. Pearson Chi square used to confirm groups evenly matched for independent prognostic markers (Primary Tumour Grade and LVI)
Results: 899 patients with SCCp underwent DSNB with 189 (21%) positive. After exclusions, 53 had unilateral disease and 11 bilateral with one or two nodes positive. Both groups statistically similar prognostic risk factors. 5-year CSS for unilateral (N1/2) was 86% (95% CI 73% - 93%) and 70% for bilateral (95% CI 32%-89%) with no statistically significant difference (p=0.28).
Conclusions: There is no significant difference in survival between unilateral and bilateral early metastatic disease. Rarity of SCCp precludes a tighter confidence interval and a larger study is required to detect if there is a small significant difference.
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