Abstract
What is so interesting about this study is just how poorly these 3 risk stratification systems perform when asked to predict the most important cancer-specific outcomes. 1 Chaux A. Risk group systems for penile cancer management: a study of 203 patients with invasive squamous cell carcinoma. Urology. 2015; 86: 790-797 Abstract Full Text Full Text PDF Scopus (9) Google Scholar Those are, of course, the risk of having positive lymph nodes and/or death from penile carcinoma in intermediate- and high-risk patients. The European Association of Urology system has an area under the curve of 0.53 for nodal status and 0.52 for cancer-related death, the equivalent of a coin toss. Clearly, our current staging and grading criteria need to be updated, or we need to look at other factors in determining risk. Perhaps alternate criteria need to be developed or genetic markers incorporated into staging and grading as has occurred with a number of other cancers. Until then, decisions regarding the judicious use of morbid interventions such as inguinal lymph node dissection and chemotherapy will continue to challenge us. Risk Group Systems for Penile Cancer Management: A Study of 203 Patients With Invasive Squamous Cell CarcinomaUrologyVol. 86Issue 4PreviewTo evaluate the accuracy of previously published risk group systems for predicting inguinal nodal metastases in patients with penile carcinoma. Full-Text PDF ReplyUrologyVol. 86Issue 4PreviewIn our experience, defining the optimal clinical management of patients with penile cancer could be problematic. Some patients do well in spite of having locally advanced tumors, whereas others exhibit tumor dissemination early in the progression of the disease. As shown in this study,1 a reason that could explain this conundrum is the use of inappropriate tools for risk evaluation in planning therapeutic and surveillance strategies. Increasing evidence suggests that relying mainly or solely on the TNM system for defining risk groups could be deceitful. Full-Text PDF
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