PROGNOSTIC FACTORS FOR LYMPH NODE INVOLVEMENT, DISEASEFREE SURVIVAL AND OVERALL SURVIVAL IN PENILE CANCER

Abstract

Background Penile Cancer (PC) is a rare neoplasm. The most important PC prognostic factor is inguinal lymph node (ILN) involvement (pN+). Inguinal lymphadenectomy (ILND) is the most accurate method for ILN staging. Due to high morbidity and quality of life impairment, alternative staging modalities have been researched. This epidemiological study aims to assess risk factors to determine prognosis in PC patients. A retrospective review was Methods conducted on 84 PC patients. Mean age was 58.68 (12.98) years. Thirty-Eight (45.3%) patients underwent ILND. The main reasons were primary tumor staging (pT2 and up) and palpable nodes (cN+) in physical examination. For pN+ risk, cN+, tumor inltration of penile body, dartos, spongios Results um and corpora cavernosa, as well as perineural and lymph vascular invasion (LVI) were signicant. For recurrence and metastasis, cN+, penile body invasion, LVI, corpora cavernosa invasion and pN+ showed statistical signicance. In overall survival (OS) evaluation, cN+, LVI, penile body, dartos, spongiosum and corpora cavernosa invasion, pT and pN+ presented worst prognosis. In multivariate analysis, cN+ was a risk factor for pN+. Cox regression analysis was also performed. Factors that decreased disease-free survival (DFS), were cN+, penile body, dartos or corpora cavernosa invasion and pN+. When applied to OS, cN+, penile body invasion, LVI, dartos invasion, pT and pN+ were related to worst survival. Most patients (67.5%) stayed disease free. Recurrence was more common on ILN (14.3%). When metastatic (10.7%), mortality was 55.6%. Conclusion This study conrmed several risk factors for pN+, DFS and OS on PC patients.