Department of Urology at The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Urology, Cleveland Clinic Florida, Weston, FL.
Urol Oncol. 2024 Apr;42(4):120.e1-120.e9. doi: 10.1016/j.urolonc.2024.01.036. Epub 2024 Feb 22.
To evaluate perioperative and oncologic outcomes of a cohort of clinically node negative high-risk penile cancer patients undergoing robotic assisted inguinal lymph node dissection (RAIL) compared to patients undergoing open superficial inguinal lymph node dissection (OSILND).
We retrospectively reviewed the clinical characteristics and outcomes of clinically node negative high-risk penile cancer patients undergoing RAIL at MDACC from 2013-2019. We sought to compare this to a contemporary open cohort of clinically node negative patients treated from 1999 to 2019 at MDACC and Moffit Cancer Center (MCC) with an OSILND. Descriptive statistics were used to characterize the study cohorts. Comparison analysis between operative variables was performed using Fisher's exact test and Wilcoxon's rank-sum test. The Kaplan-Meier method was used to estimate survival endpoints.
There were 24 patients in the RAIL cohort, and 35 in the OSILND cohort. Among the surgical variables, operative time (348.5 minutes vs. 239.0 minutes, P < 0.01) and the duration of operative drain (37 vs. 22 days P = 0.017) were both significantly longer in the RAIL cohort. Complication incidences were similar for both cohorts (34.3% for OSILND vs. 33.3% for RAIL), with wound complications making up 33% of all complications for RAIL and 31% of complications for OSILND. No inguinal recurrences were noted in either cohort. The median follow-up was 40 months for RAIL and 33 months for OSILND.
We observed similar complication rates and surgical variable outcomes in our analysis apart from operative time and operative drain duration. Oncological outcomes were similar between the two cohorts. RAIL was a reliable staging and potentially therapeutic procedure among clinically node negative patients with penile squamous cell carcinoma with comparable outcomes to an OSILND cohort.
评估一组接受机器人辅助腹股沟淋巴结清扫术（RAIL）的临床淋巴结阴性高危阴茎癌患者与接受开放式浅表腹股沟淋巴结清扫术（OSILND）的患者的围手术期和肿瘤学结果。
我们回顾性地审查了 2013 年至 2019 年期间在 MDACC 接受 RAIL 的临床淋巴结阴性高危阴茎癌患者的临床特征和结果。我们试图将这与 1999 年至 2019 年在 MDACC 和 Moffit 癌症中心（MCC）接受 OSILND 治疗的具有临床淋巴结阴性的同期开放队列进行比较。使用描述性统计数据来描述研究队列。使用 Fisher 精确检验和 Wilcoxon 秩和检验对手术变量进行比较分析。Kaplan-Meier 方法用于估计生存终点。
RAIL 队列中有 24 例患者，OSILND 队列中有 35 例患者。在手术变量中，手术时间（348.5 分钟 vs. 239.0 分钟，P < 0.01）和手术引流管持续时间（37 天 vs. 22 天，P=0.017）在 RAIL 队列中均明显更长。两个队列的并发症发生率相似（OSILND 为 34.3%，RAIL 为 33.3%），RAIL 的所有并发症中有 33%为伤口并发症，OSILND 的并发症中有 31%为伤口并发症。两个队列均未出现腹股沟复发。RAIL 的中位随访时间为 40 个月，OSILND 的中位随访时间为 33 个月。
除了手术时间和手术引流管持续时间外，我们在分析中观察到手术变量结果和并发症发生率相似。两个队列的肿瘤学结果相似。在具有阴茎鳞状细胞癌的临床淋巴结阴性患者中，RAIL 是一种可靠的分期和潜在的治疗方法，其结果与 OSILND 队列相当。
