Department of Urology, Baoji People's Hospital, Baoji, Shaanxi, China.
Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China.
Int Braz J Urol. 2022 Mar-Apr;48(2):303-313. doi: 10.1590/S1677-5538.IBJU.2021.0613.
To determine independent predictors of inguinal lymph node (ILN) metastasis in patients with penile cancer.
We retrospectively analyzed all patients with penile cancer who underwent surgery at our medical center in the last ten years (n=157). Using univariate and multivariate logistic-regression models, we assessed associations with age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs measured by imaging, pathological T stage, degree of tumor differentiation and/or cornification, lymphatic vascular infiltration (LVI), nerve infiltration, and ILN metastases. Interaction and stratified analyses were used to assess age, phimosis, onset time, number of ILNs, cornification, and nerve infiltration.
A total of 110 patients were included in the study. Multiple logistic regression analysis showed that the following factors were significantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter ≥1.5cm, 50% had lymph node metastasis whereas 30.6% patients with a maximum ILN diameter <1.5cm showed LNM. Among 44 patients with stage Ta/T1, 10 showed ILN metastases, while 47.0% patients with stage T2 showed ILN metastases. Among 40 patients with highly differentiated penile-cancer, eight showed ILN metastasis, while 47.1% patients with low-to-middle differentiation showed ILN metastases. The rate of LNM was 33.3% in the LVI-free group and 64.3% in the LVI group.
Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.
确定阴茎癌患者腹股沟淋巴结（ILN）转移的独立预测因素。
我们回顾性分析了过去十年在我们医疗中心接受手术治疗的所有阴茎癌患者（n=157）。使用单变量和多变量逻辑回归模型，我们评估了年龄、病史、包茎、发病时间、影像学测量的受累 ILN 数量和最大直径、病理 T 分期、肿瘤分化程度和/或角化程度、淋巴血管浸润（LVI）、神经浸润以及 ILN 转移与这些因素的相关性。使用交互和分层分析来评估年龄、包茎、发病时间、ILN 数量、角化和神经浸润。
共有 110 例患者纳入研究。多变量逻辑回归分析显示，以下因素与 ILN 转移显著相关：增大的 ILN 的最大直径、T 分期、病理分化和 LVI。在最大 ILN 直径≥1.5cm 的患者中，有 50%发生淋巴结转移，而最大 ILN 直径<1.5cm 的患者中有 30.6%出现 LNM。在 44 例 Ta/T1 期患者中，有 10 例出现 ILN 转移，而在 47.0%的 T2 期患者中出现 ILN 转移。在 40 例高分化阴茎癌患者中，有 8 例出现 ILN 转移，而在 47.1%低-中分化的患者中出现 ILN 转移。在无 LVI 组，LNM 发生率为 33.3%，在 LVI 组，LNM 发生率为 64.3%。
我们的单中心研究结果表明，最大 ILN 直径、病理 T 分期、病理分化和 LVI 是 ILN 转移的独立危险因素。
