A National Cancer Database-based nomogram to predict lymph node metastasis in penile cancer

2019 ◽  
Vol 123 (6) ◽  
pp. 1005-1010 ◽  
Author(s):  
Taylor C. Peak ◽  
Gregory B. Russell ◽  
Rahul Dutta ◽  
Michael B. Rothberg ◽  
Andrew G. Chapple ◽  
...  
2021 ◽  
Vol 11 ◽  
Author(s):  
Han Li ◽  
Yucheng Ma ◽  
Zhongyu Jian ◽  
Xi Jin ◽  
Liyuan Xiang ◽  
...  

Background and AimsThe current guidelines for the treatment of penile cancer patients with clinically non-invasive normal inguinal lymph nodes are still broad, so the purpose of this study is to determine which patients are suitable for lymph node dissection (LND).MethodsHistologically confirmed penile cancer patients (primary site labeled as C60.9-Penis) from 2004 to 2016 in the Surveillance, Epidemiology, and Results database were included in this analysis. Univariate and multivariate Cox regression analyses were applied to determine an overall estimate of LND on overall survival and cancer-specific survival. A 1:1 propensity matching analysis (PSM) was applied to enroll balanced baseline cohort, and further Kaplan–Meier (KM) survival analysis was used to get more reliable results.ResultsOut of 4,458 histologically confirmed penile cancer patients with complete follow-up information, 1,052 patients were finally enrolled in this analysis. Age, pathological grade, T stage, and LND were identified as significant predictors for overall survival (OS) in the univariate Cox analysis. In the multivariate Cox regression, age, pathological grade, T stage, and LND were found significant. The same results were also found in the univariate and multivariate Cox regression analyses for cancer-specific survival (CSS). After the successful PSM, further KM analysis revealed that LND could bring significant OS and CSS benefits for T3T4 patients without lymph node metastasis.ConclusionLymph node dissection may bring survival benefits for penile cancer patients without preoperatively detectable lymph node metastasis, especially for T3T4 stage patients. Further randomized control trial is needed.


2009 ◽  
Vol 16 (4) ◽  
pp. 383-386 ◽  
Author(s):  
Aravind Ramkumar ◽  
Ramakrishnan Ayloor Seshadri ◽  
Kathiresan Narayanaswamy ◽  
Satheesan Balasubramanian

2013 ◽  
Vol 189 (4S) ◽  
Author(s):  
Kai Yao ◽  
Hui Han ◽  
Jing Li ◽  
Fang-jian Zhou ◽  
Zi-ke Qin ◽  
...  

2021 ◽  
Author(s):  
Yanxiang Shao ◽  
Kan Wu ◽  
Thongher Lia ◽  
Xu Hu ◽  
Shangqing Ren ◽  
...  

Abstract Objective To investigate the predictive factors of lymph node metastasis (LNM) and evaluate the usefulness of prediction nomograms. Methods This study analyzed data of 300 patients diagnosed with penile squamous cell carcinoma at West China Hospital (WCH) of Sichuan University (Chengdu, China) and 412 cases acquired from the Surveillance, Epidemiology, and End Results (SEER) program. Logistic regression analysis was performed on these cohorts to investigate the predictive factors of LNM. We evaluated a recently developed prediction nomogram for LNM, which was established based on the National Cancer Database (NCDB). Moreover, we developed a novel nomogram using cases from the WCH for the prediction of lymphatic metastasis. Results Logistic analysis identified that younger age at diagnosis, invasion of the penis body, poorer pT stage, cN stage, nuclear grade and the presence of lymph vascular invasion (LVI) were significantly correlated with LNM in WCH cases; however, only race, poorer T stage and cN stage were significantly associated with LNM among the cases from the SEER. Multivariate analysis demonstrated that younger age, poorer T stage, cN stage and nuclear grade were independent predictors of LNM. Receiver operating characteristic curve analysis of WCH cases showed that the tumor T stage 8th edition has better area under the curve than 7th stage (0.672 vs 0.636, respectively). Moreover, well AUC were seen in external validation of NCDB nomogram in WCH cohorts and SEER series (0.833 vs 0.795). The new nomogram included the aforementioned independent predictors and the bootstrap-corrected concordance was 0.876. Conclusion Younger diagnose age, poorer pT stage, cN stage, nuclear grade and LVI were the most important predictors of LNM in patients with penile cancer. 8th T stage performed better than 7th version in predicting LNM. NCDB nomogram have some application value in both WCH and SEER cases, and our novel model further improved the predictive accuracy.


2021 ◽  
Vol 11 ◽  
Author(s):  
Chong Wu ◽  
Zaishang Li ◽  
Shengjie Guo ◽  
Fangjian Zhou ◽  
Hui Han

PurposeTo determine whether a clinicopathologic and laboratory-based nomogram is capable of predicting the risk of lymph node extranodal extension (ENE) in patients with penile cancer.Materials and MethodsFrom June 2006 to January 2021, 234 patients who underwent bilateral inguinal lymph node dissection (ILND) surgery were included in the analysis. A Lasso regression model was utilized to select the most useful predictive features from among 46 laboratory variables. Then, a logistic regression analysis was used to develop the prediction model. Calibration curves, concordance index (C-index) and Areas under the receiver-operating characteristic curves (AUCs) were performed to evaluate the performance of the nomogram. We also investigated model fit using changes in Akaike Information Criteria (AICs). Decision curve analyses (DCAs) were applied to assess the clinical usefulness of this nomograms. Its internal validation was confirmed.ResultsAmong the 234 patients, 53 were confirmed to have ENE. The platelet-lymphocyte ratio (PLR) and Squamous cell carcinoma antigen (SCC-Ag) were significantly associated with ENE (P<0.05). The individualized prediction nomogram, including the PLR, SCC-Ag, lymphovascular invasion (LVI), and pathologic tumor stage(pT-stage), showed good discrimination, with a C-index of 0.817 (95% CI, 0.745 to 0.890) and good calibration. Clinical-laboratory nomogram (AIC, 180.034) become the best-fitting model. DCA findings revealed that the clinical-laboratory nomogram was more clinically useful than the pT-stage or tumor grade.ConclusionsThis study presents a clinicopathologic and laboratory-based nomogram that incorporates PLR, SCC-Ag, lymphovascular invasion (LVI), and pT-stage, which can be conveniently utilized to facilitate the individualized prediction of lymph node metastasis ENE in patients with penile cancer.


2020 ◽  
Author(s):  
Wenwen Zheng ◽  
Zhiyu Zhang ◽  
Xilei Xie ◽  
Weiwei Zhu ◽  
Kangqi Li ◽  
...  

Abstract Background: The objective of this study was to investigate the prognostic value of tumor size on cancer-specific mortality (CSM) and lymph node metastasis for patients with penile squamous cell carcinoma (PSCC).Method: The patients diagnosed with PSCC between 2004 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Restricted cubic spline functions were calculated to characterize the association between tumor size and the risk of CSM. The competing-risks model was used to evaluate the impact of tumor size on the cumulative incidence of CSM. The logistic regression analysis was performed to examine the association between tumor size and lymph node metastasis.Results: Totally, 1365 PSCC patients were analyzed, with 52.3% having tumors ≤30 mm, and 47.7% >30 mm. The restricted cubic splines showed that the risks of CSM increased as tumors enlarged. Following adjustment of competing events, the PSCC patients with tumors >30 mm were more likely to succumb to CSM in comparison with those with tumors ≤30 mm (hazard ratio [HR]=1.57, 95% confidence interval [CI]: 1.23-2.01, P<0.001). In subgroup analyses, tumor size >30 mm was significantly associated with an increased risk of CSM relative to tumor size ≤30 mm among patients with T1 (HR=1.56, 95%CI: 1.03-2.37, P=0.036) and T3 (HR=2.51, 95%CI: 1.41-4.45, P=0.002) classifications. On logistic regression analysis, tumors >30 mm were significantly associated with lymph node metastasis (odds ratio [OR]=1.46, 95% CI: 1.03-2.07, P=0.034).Conclusion: Larger tumors (>30 mm) were significantly associated with higher risks of CSM and increased likelihood of lymph node metastasis for PSCC patients, which could be integrated into the development of a staging system for penile cancer.


2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Derya Tilki ◽  
Boris Schlenker ◽  
Oliver Reich ◽  
Michael Seitz ◽  
Christian Stief ◽  
...  

2021 ◽  
Vol Volume 13 ◽  
pp. 7429-7437
Author(s):  
Yanxiang Shao ◽  
Xiang Tu ◽  
Yang Liu ◽  
Yige Bao ◽  
Shangqing Ren ◽  
...  

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