MP76-13 EXAMINING THE SURVIVAL BENEFIT OF INGUINAL LYMPH NODE DISSECTION IN MEN WITH CN0 PENILE CANCER

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer III (MP76)1 Apr 2020MP76-13 EXAMINING THE SURVIVAL BENEFIT OF INGUINAL LYMPH NODE DISSECTION IN MEN WITH CN0 PENILE CANCER Pooja Unadkat*, Aaron Fleishman, Aria Olumi, Andrew Wagner, Peter Chang, Simon Kim, Ruslan Korets, and Boris Gershman Pooja Unadkat*Pooja Unadkat* More articles by this author , Aaron FleishmanAaron Fleishman More articles by this author , Aria OlumiAria Olumi More articles by this author , Andrew WagnerAndrew Wagner More articles by this author , Peter ChangPeter Chang More articles by this author , Simon KimSimon Kim More articles by this author , Ruslan KoretsRuslan Korets More articles by this author , and Boris GershmanBoris Gershman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000962.013AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Inguinal lymph node dissection (ILND) is recommended for men with clinically node-negative (cN0) penile cancer at increased risk of harboring lymph node (LN) metastases. However, the evidence supporting a survival benefit to ILND is limited to older, small, observational studies. We therefore examined the associations of ILND with survival among men with cN0 penile cancer. METHODS: We identified 1,760 adult men with cTany cN0 cM0 squamous cell carcinoma of the penis treated with partial/radical penectomy with or without ILND in the National Cancer Database from 2006-2015. A propensity score for ILND was estimated using logistic regression, and the associations of ILND with overall survival (OS) were evaluated using Cox regression after adjusting for inverse probability of treatment weights (IPW). RESULTS: Mean age at diagnosis was 67 years. Primary tumors were ≤pT1 in 864 (49%), pT2 in 585 (33%), and pT3/T4 in 311 (18%) patients. Grade was 1-2 in 1411 (80%) and 3-4 in 349 (20%) patients. Median number of LNs removed in the ILND group was 15 (IQR 8-23). Baseline characteristics were well-balanced after IPW-adjustment. Median follow-up was 28.2 (IQR 13.1-50.0) months. During follow-up, a total of 564 patients died of any cause. In the overall cohort, ILND was not associated with a difference in OS after IPW-adjustment (HR 1.02; 95% CI 0.74-1.41; p=0.91). When stratified by grade and pT stage, ILND was associated with a statistically significant improvement in OS among patients with grade 3-4 tumors only (HR 0.52; 95% CI 0.40-0.67; p=0.007) (Table). CONCLUSIONS: Among men with cN0 penile cancer, ILND was associated with improved OS for patients with grade 3-4 tumors only. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1156-e1156 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pooja Unadkat* More articles by this author Aaron Fleishman More articles by this author Aria Olumi More articles by this author Andrew Wagner More articles by this author Peter Chang More articles by this author Simon Kim More articles by this author Ruslan Korets More articles by this author Boris Gershman More articles by this author Expand All Advertisement PDF downloadLoading ...