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Li ZS, Li XY, Wang B, Chen P, Li X, Augusto OA, Qin ZK, Liu ZW, Li YH, Han H, Zhou FJ. Radiotherapy plus chemotherapy versus chemotherapy alone in penile cancer patients with extracapsular nodal extension after inguinal lymph node surgery: a multi-institutional study. World J Urol 2020; 39:113-119. [PMID: 32303900 DOI: 10.1007/s00345-020-03179-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 03/23/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Because there is a lack of evidence, it is not generally recommended to use adjuvant radiotherapy plus chemotherapy to treat lymph node disease in penile cancer. The aim of this study was to determine the benefit of using adjuvant radiotherapy after inguinal surgery for penile cancer. METHODS Multi-institutional data were obtained from a total of nine centers from April 2003 to April 2015 and retrospectively analyzed. pN3 patients with an extracapsular nodal extension who received adjuvant therapy after inguinal surgery were included. Cancer-specific survival (CSS) was estimated using the Kaplan-Meier method. The multivariate analysis was performed using a Cox proportional hazards model. RESULTS A total of 93 pN3 patients met the inclusion criteria. During the study period, 32 (34.4%) and 61 (65.6%) of these patients received adjuvant radiotherapy plus chemotherapy (AR + AC) or adjuvant chemotherapy alone (AC). The median CSS in all patients was 12.0 months (interquartile range [IQR] 7.5-16.5). The Kaplan-Meier estimated 3-year CSS rate was significantly longer in the AR + AC group (28.5%) than the AC group (16.2%) (p = 0.036). AC + AR was associated with an improvement in CSS by 7.7 months (17.7 [IQR 3.8-31.6] vs. 10.0 [IQR 6.6-13.4] months). In the Cox regression analysis, AR + AC was an independent predictor of CSS [model a: HR 0.486 (95% CI 0.258-0.916), model b: HR 0.527 (95% CI 0.286-0.972)]. CONCLUSION In conclusions, AR + AC was associated with improved CCS in patients with penile cancer who displayed an extracapsular nodal extension after inguinal surgery. This hypothesis requires further confirmation.
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Affiliation(s)
- Zai-Shang Li
- Department of Urology, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical College of Jinan University, Shenzhen, P. R. China.,Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China.,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China
| | - Xue-Ying Li
- Department of Oncology, The Seventh Affiliated Hospital Sun Yat-Sen University, Shenzhen, Guangdong, P. R. China
| | - Bin Wang
- Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, P. R. China
| | - Peng Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, P. R. China
| | - Xiang Li
- Department of Urology, West China Hospital, Chengdu, P. R. China
| | | | - Zi-Ke Qin
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China.,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China
| | - Zhuo-Wei Liu
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China.,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China
| | - Yong-Hong Li
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China.,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China.,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China
| | - Hui Han
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China. .,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China. .,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China.
| | - Fang-Jian Zhou
- Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China. .,State Key Laboratory of Oncology in Southern China, Guangzhou, P. R. China. .,Collaborative Innovation Center of Cancer Medicine, Guangzhou, P. R. China.
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Eardley I. Re: Prognostic Factors Influencing Survival from Regionally Advanced Squamous Cell Carcinoma of the Penis after Preoperative Chemotherapy. Eur Urol 2016; 70:894-895. [PMID: 27567203 DOI: 10.1016/j.eururo.2016.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Ian Eardley
- Department of Urology, St James University Hospital, Leeds, West Yorkshire, UK.
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