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.
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.
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)].
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.
World journal of urology. 2020 Apr 17 [Epub ahead of print]
Zai-Shang Li, Xue-Ying Li, Bin Wang, Peng Chen, Xiang Li, Ornellas Antonio Augusto, Zi-Ke Qin, Zhuo-Wei Liu, Yong-Hong Li, Hui Han, Fang-Jian Zhou
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 Oncology, The Seventh Affiliated Hospital Sun Yat-Sen University, Shenzhen, Guangdong, P. R. China., Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, P. R. China., Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, P. R. China., Department of Urology, West China Hospital, Chengdu, P. R. China., Department of Urology, Brazilian National Cancer Institute, Rio de Janeiro, Brazil., Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China., Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China. ., Department of Urology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, P. R. China. .