Adjuvant chemotherapy is associated with improved overall survival in pelvic node–positive penile cancer after lymph node dissection: A multi-institutional study

Abstract Objectives We determined whether adjuvant chemotherapy (AC) would be associated with improved survival after lymph node dissection (LND) for patients with penile cancer (PeCa) who have positive pelvic lymph nodes (PPLNs). Methods We retrospectively identified patients across 4 centers with...

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Published in:Urologic oncology 2015-11, Vol.33 (11), p.496.e17-496.e23
Main Authors: Sharma, Pranav, M.D, Djajadiningrat, Rosa, M.D, Zargar-Shoshtari, Kamran, M.D, Catanzaro, Mario, M.D, Zhu, Yao, M.D, Nicolai, Nicola, M.D, Horenblas, Simon, M.D., Ph.D, Spiess, Philippe E., M.D
Format: Article
Language:English
Subjects:
Adjuvant chemotherapy
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Squamous Cell - drug therapy
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Chemotherapy, Adjuvant
Follow-Up Studies
Humans
Lymph node dissection
Lymph Node Excision - mortality
Lymph Nodes - pathology
Lymph Nodes - surgery
Male
Middle Aged
Neoplasm Staging
Overall survival
Pelvis - pathology
Penile cancer
Penile Neoplasms - drug therapy
Penile Neoplasms - mortality
Penile Neoplasms - pathology
Prognosis
Retrospective Studies
Squamous cell carcinoma
Survival Rate
Urology
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Summary:Abstract Objectives We determined whether adjuvant chemotherapy (AC) would be associated with improved survival after lymph node dissection (LND) for patients with penile cancer (PeCa) who have positive pelvic lymph nodes (PPLNs). Methods We retrospectively identified patients across 4 centers with penile squamous cell carcinoma who underwent LND from 1978 to 2013 and were found to have PPLNs. Patients who received chemotherapy before surgery or in the presence of recurrent disease were excluded. Cox regression was used to evaluate the association of AC with overall survival (OS), which was estimated using the Kaplan-Meier method. Differences in OS were determined with the log-rank test. Results During the study period, 141 patients who underwent LND for PeCa had PPLNs, and 84 of them met inclusion criteria. Median number of PPLNs was 2 (interquartile range [IQR]: 4–7), with 10% of cases occurring bilaterally and 55% having pelvic extranodal extension. AC was used in 36 (43%) patients. Patients who received AC were younger ( P = 0.014), had less-aggressive penile tumor pathology ( P
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2015.05.008