Li Zaishang, Li Xueying, Lam Wayne, Cao Yabing, Geng Jiunhung, Ornellas Antonio Augusto, Zhou Fangjian, Han Hui
Department of Urology, Shenzhen People's Hospital, The Second Clinic Medical College of Jinan University 518060, Shenzhen, Guangdong, P. R. China.
Department of Urology, First Affiliated Hospital of Southern University of Science and Technology, 518060, Shenzhen, Guangdong, P. R. China.
J Cancer. 2021 Jan 30;12(7):1960-1966. doi: 10.7150/jca.56504. eCollection 2021.
Changes were made in the 8 edition of the American Joint Committee on Cancer (AJCC) staging system according to cavernosum invasion for penile squamous cell carcinoma. This study aimed to determine the difference of prognostic validity between corpora cavernosa (CC) invasion and corpus spongiosum (CS) invasion. In this study, we searched PubMed, Cochrane CENTRAL, and Embase to select English-language articles until July 15, 2020. Pooled analyses of hazard ratios (HRs) and odds ratios (ORs) were performed. Eleven studies including 3692 cases were included in the final ananlysis (1431 cases with CC and 1360 cases with CS). According to the anatomical structure, the pooled results demonstrated that patients with CC invasion had a similar rate of LNM to those with CS invasion (OR 1.34, 95% confidence interval (CI) 0.97-1.86; =0.076). However, patients with CC invasion had a higher rate of lymph node metastasis (LNM) than those with CS invasion according to the 8 edition tumor stage (OR 1.58, 95% CI 1.14-2.21; <0.001). Regarding survival, patients with CS invasion obtained a significantly better cancer-specific survival (CSS) (HR, 0.67; 95% CI, 0.46-0.96; =0.030), but not in overall survival (OS) (HR: 1.30; 95% CI, 0.52-3.20; =0.585) than those with CC invasion. No a significant publication bias was observed by Begg's and Egger's tests. The systematic comparison suggests that patients with CS invasion had better CSS than those with CC invasion. CC invasion was associated with a high risk of LNM. The conclusions should be validated by large-scale studies.
美国癌症联合委员会(AJCC)分期系统第8版根据阴茎鳞状细胞癌的海绵体侵犯情况做出了改变。本研究旨在确定海绵体(CC)侵犯和尿道海绵体(CS)侵犯在预后有效性方面的差异。在本研究中,我们检索了PubMed、Cochrane CENTRAL和Embase以选择截至2020年7月15日的英文文章。进行了风险比(HRs)和比值比(ORs)的汇总分析。最终分析纳入了11项研究,共3692例病例(1431例CC侵犯病例和1360例CS侵犯病例)。根据解剖结构,汇总结果显示CC侵犯患者的淋巴结转移(LNM)率与CS侵犯患者相似(OR 1.34,95%置信区间(CI)0.97 - 1.86;P = 0.076)。然而,根据第8版肿瘤分期,CC侵犯患者的淋巴结转移(LNM)率高于CS侵犯患者(OR 1.58,95% CI 1.14 - 2.21;P < 0.001)。关于生存情况,CS侵犯患者的癌症特异性生存(CSS)明显更好(HR,0.67;95% CI,0.46 - 0.96;P = 0.030),但总生存(OS)方面与CC侵犯患者相比无差异(HR:1.30;95% CI,0.52 - 3.20;P = 0.585)。Begg检验和Egger检验未观察到显著的发表偏倚。系统比较表明,CS侵犯患者的CSS优于CC侵犯患者。CC侵犯与LNM的高风险相关。这些结论应通过大规模研究进行验证。