MP80-14 LYMPH NODE YIELD AS A PREDICTOR OF OVERALL SURVIVAL FOLLOWING REGIONAL LYMPHADENECTOMY FOR PENILE CANCER

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease III1 Apr 2017MP80-14 LYMPH NODE YIELD AS A PREDICTOR OF OVERALL SURVIVAL FOLLOWING REGIONAL LYMPHADENECTOMY FOR PENILE CANCER Chad Ritch, Nachiketh Soodana Prakash, Varsha Sinha, Diana M Lopategui, Katherine Almengo, Micheal Ahdoot, David Alonzo, Mahmoud Alameddine, Sanoj Punnen, Dipen Parekh, and Mark Gonzalgo Chad RitchChad Ritch More articles by this author , Nachiketh Soodana PrakashNachiketh Soodana Prakash More articles by this author , Varsha SinhaVarsha Sinha More articles by this author , Diana M LopateguiDiana M Lopategui More articles by this author , Katherine AlmengoKatherine Almengo More articles by this author , Micheal AhdootMicheal Ahdoot More articles by this author , David AlonzoDavid Alonzo More articles by this author , Mahmoud AlameddineMahmoud Alameddine More articles by this author , Sanoj PunnenSanoj Punnen More articles by this author , Dipen ParekhDipen Parekh More articles by this author , and Mark GonzalgoMark Gonzalgo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2519AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is limited data to define an appropriate threshold for lymph node yield (LNY) following regional lymphadenectomy (rND) for penile squamous cell carcinoma (pSCC) and, whether that specific threshold impacts overall survival (OS). We sought to determine whether a specific LNY affects OS following rND for pSCC and, to define the minimum beneficial number of lymph nodes (LN) to retrieve. METHODS Using the National Cancer Database (NCDB), we identified men diagnosed with pSCC, who underwent rND, from 2004 to 2013. We excluded men diagnosed on autopsy or at the time of death, with preoperative chemotherapy or radiotherapy, M+ disease, and with < 3 months of follow up. We assessed the statistical distribution of LNY following rND. A multivariable logistic regression model was developed to assess predictors of OS including: age, comorbidity, race, stage, grade, nodal status, and LNY. Kaplan-Meier (KM) survival analysis was performed to compare OS by varying thresholds of LNY. RESULTS 938 men with pSCC underwent rND. Of these 452 met inclusion criteria. Median follow up was 29.9 months. The median number of regional LN retrieved was 16. Based on the statistical distribution of LNY and, sensitivity analysis, a threshold of 15 LNs appeared to be clinically and statistically relevant. There was no significant difference in race, stage, grade for men with LNY ≤15 vs >15. However, men with LNY ≤ 15 were older than those with LNY >15 (64 vs 58 years, p<0.01). On multivariable analysis, significant independent predictors of worse OS were: age (HR: 1.02; CI [1-1.03], p<0.05), N+ disease (HR: 3.06; CI [2.12-4.42], p<0.001), and LNY ≤ 15 (HR: 1.62; CI [1.17-2.24], p<0.01). Men with a LNY ≤ 15 demonstrated a significantly decreased 5-year OS compared to those with LNY > 15 (50% VS 73%, p<0.05). On subgroup analysis of men with T2, N0, LNY >15 trended toward better 5-year OS vs LNY ≤15 (90% VS 71%, p=0.06) (Figure) CONCLUSIONS LNY following rND for pSCC appears to have an impact on OS independent of age, stage, nodal status and grade. A minimum LNY >15 following rND may have a beneficial impact on OS and may serve as the quantitative threshold for defining an adequate rND. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1086 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Chad Ritch More articles by this author Nachiketh Soodana Prakash More articles by this author Varsha Sinha More articles by this author Diana M Lopategui More articles by this author Katherine Almengo More articles by this author Micheal Ahdoot More articles by this author David Alonzo More articles by this author Mahmoud Alameddine More articles by this author Sanoj Punnen More articles by this author Dipen Parekh More articles by this author Mark Gonzalgo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...