PD53-07 RISK OF INGUINAL LYMPH NODE METASTASES IN MEN WITH T1G2 PENILE CANCER STRATIFIED BY LYMPHOVASCULAR INVASION

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer II (PD53)1 Sep 2021PD53-07 RISK OF INGUINAL LYMPH NODE METASTASES IN MEN WITH T1G2 PENILE CANCER STRATIFIED BY LYMPHOVASCULAR INVASION Christian Fankhauser, Hielke M. de Vries, Eduard Roussel, Jakob Kristian Jakobsen, Allaudin Issa, Esther W. C. Lee, Pedro Oliveira, Maurice Lau, Arie Parnham, Maarten Albersen, Nicholas A. Watkin, Ben E. Ayres, Oscar R. Brouwer, and Vijay Sangar Christian FankhauserChristian Fankhauser More articles by this author , Hielke M. de VriesHielke M. de Vries More articles by this author , Eduard RousselEduard Roussel More articles by this author , Jakob Kristian JakobsenJakob Kristian Jakobsen More articles by this author , Allaudin IssaAllaudin Issa More articles by this author , Esther W. C. LeeEsther W. C. Lee More articles by this author , Pedro OliveiraPedro Oliveira More articles by this author , Maurice LauMaurice Lau More articles by this author , Arie ParnhamArie Parnham More articles by this author , Maarten AlbersenMaarten Albersen More articles by this author , Nicholas A. WatkinNicholas A. Watkin More articles by this author , Ben E. AyresBen E. Ayres More articles by this author , Oscar R. BrouwerOscar R. Brouwer More articles by this author , and Vijay SangarVijay Sangar More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002080.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In men with penile cancer, early detection and removal of inguinal lymph nodes (ILN) with metastatic disease is important as most patients can be cured with ILN dissection at this early metastatic stage. Current guidelines recommend invasive ILN staging in men with >T1G2 penile cancer and surveillance in ≤T1G1. In men with T1G2, the European Association of Urology guideline does not clearly specify whether invasive ILN staging is needed whereas the National Comprehensive Cancer Network guidelines only recommend invasive ILN staging in T1G2 with lymphovascular invasion (LVI). The aim of this analysis was to reassess the risk of ILN metastases in T1G2 disease and whether the stratification based on LVI is helpful in predicting ILN metastases and should influence the decision to perform invasive ILN staging. METHODS: We performed a retrospective cohort analysis of men presenting with localised T1G2 penile cancer with non-palpable lymph nodes and no local recurrence during follow-up at five European institutional high-volume centres. Patient characteristics, pathological and survival outcomes were extracted from electronic health records. ILN involvement was defined as cancer detected during ultrasound guided fine needle aspiration or core needle biopsy, dynamic sentinel lymph node biopsy, ILN dissection or inguinal recurrence during follow-up. Descriptive analyses and binary regression analyses were performed. RESULTS: The cohort included 477 men with a mean age of 65 years (±13), with pure squamous cell carcinoma in 90%, basaloid/warty/sarcomatoid variants in 7% and other variants or missing in 3%. During a median follow-up of 27 months (IQR 11-62), any ILN involvement was observed in 42/477 men (9%, 95% confidence interval (CI) 6-11%) of which 17/42 died, 5 because of penile cancer and 12 because of non-cancer associated reasons. LVI was present in 30, absent in 417 and missing in 30 men. Men with LVI patients had higher odds for ILN metastases compared to men without LVI (OR 3.9, 95% CI 1.5-6.5, p-value<0.01). Expressed as proportions, men with LVI had a ILN metastases risk of 23% (95% CI 10-42%) compared to 7% in men without LVI (95% CI 5-10%, p-value <0.01). CONCLUSIONS: In men with T1G2 cN0 penile cancer, LVI is a rare but strong risk factor for ILN metastases. Further analyses are required to balance the risk and benefits of invasive ILN staging in men with T1G2 without LVI. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e918-e919 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Fankhauser More articles by this author Hielke M. de Vries More articles by this author Eduard Roussel More articles by this author Jakob Kristian Jakobsen More articles by this author Allaudin Issa More articles by this author Esther W. C. Lee More articles by this author Pedro Oliveira More articles by this author Maurice Lau More articles by this author Arie Parnham More articles by this author Maarten Albersen More articles by this author Nicholas A. Watkin More articles by this author Ben E. Ayres More articles by this author Oscar R. Brouwer More articles by this author Vijay Sangar More articles by this author Expand All Advertisement Loading ...