You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease (III)1 Apr 2013942 THE RELATIONSHIP BETWEEN LYMPH-NODE DENSITY AND CANCER-SPECIFIC SURVIVAL IN A CONTEMPORARY SERIES OF PATIENTS WITH PENILE CANCER Giovanni Lughezzani, Mario Catanzaro, Nicola Nicolai, Tullio Torelli, Luigi Piva, Davide Biasoni, Silvia Stagni, Andrea Necchi, Patrizia Giannatempo, Daniele Raggi, Elena Farè, Maurizio Colecchia, and Roberto Salvioni Giovanni LughezzaniGiovanni Lughezzani Milano, Italy More articles by this author , Mario CatanzaroMario Catanzaro Milano, Italy More articles by this author , Nicola NicolaiNicola Nicolai Milano, Italy More articles by this author , Tullio TorelliTullio Torelli Milano, Italy More articles by this author , Luigi PivaLuigi Piva Milano, Italy More articles by this author , Davide BiasoniDavide Biasoni Milano, Italy More articles by this author , Silvia StagniSilvia Stagni Milano, Italy More articles by this author , Andrea NecchiAndrea Necchi Milano, Italy More articles by this author , Patrizia GiannatempoPatrizia Giannatempo Milano, Italy More articles by this author , Daniele RaggiDaniele Raggi Milano, Italy More articles by this author , Elena FarèElena Farè Milano, Italy More articles by this author , Maurizio ColecchiaMaurizio Colecchia Milano, Italy More articles by this author , and Roberto SalvioniRoberto Salvioni Milano, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.521AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lymph node density (LND; ratio of positive lymph nodes to the total number of lymph nodes removed) is an established predictor of survival in several malignancies. In the current study, we evaluated the association between LND and cancer-specific survival (CSS) in a population of patients with penile cancer and pathologically-determined lymph node metastases. METHODS We retrieved data from 81 patients with pathologically-determined LNM who were surgically treated at our Institution between 2000 and 2012. The minimum p-value method according to Mazumdar-Glassman was used to determine the most significant LND cut-off value. LND was considered both as a continuously-coded and as a categorically-coded variable. The Kaplan-Meier method was used to determine CSS rates. Univariable and multivariable Cox regression models were fitted to test the predictors of CSS. RESULTS The median number of positive and removed lymph nodes were 2 (IQR: 1-4) and 22 (IQR: 13-30), respectively. Median LND was 10.3% (IQR: 6.3 -16.6) and the most significant LND cut-off value was 22%. Median follow-up was 26 months (Interquartile range; IQR: 16-62). Overall, 5-year CSS rate was 50.5%. After stratification according to LND, 5-year CSS rates was 65.2 vs. 9.6% in patients with LND < vs. >= 22, respectively (p<0.001). At univariable Cox regression models, both continuously-coded (HR: 1.02, 95% CI: 1.01-1.03; p=0.006) and categorically-coded LND (HR: 4.55; 95% CI: 2.20-9.38; p<0.001) were significant predictors of CSS. At multivariable Cox regression models, after adjusting for several established prognostic factors, categorically-coded LND emerged as the only independent predictor of CSS (HR: 4.28; 95% CI: 1.65-11.08; p=0.003). CONCLUSIONS Lymph node density is a powerful predictor of CSS in patients with penile cancer and pathologically-determined LNM. Although further investigations are needed to evaluate the relationship between tumor burden and treatment intensity, LND may be of immediate use in clinical practice to better stratify the prognosis of these patients. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e387 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Lughezzani Milano, Italy More articles by this author Mario Catanzaro Milano, Italy More articles by this author Nicola Nicolai Milano, Italy More articles by this author Tullio Torelli Milano, Italy More articles by this author Luigi Piva Milano, Italy More articles by this author Davide Biasoni Milano, Italy More articles by this author Silvia Stagni Milano, Italy More articles by this author Andrea Necchi Milano, Italy More articles by this author Patrizia Giannatempo Milano, Italy More articles by this author Daniele Raggi Milano, Italy More articles by this author Elena Farè Milano, Italy More articles by this author Maurizio Colecchia Milano, Italy More articles by this author Roberto Salvioni Milano, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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