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Lymph node metastases and prognosis in penile cancer

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Chinese Journal of Cancer Research

Abstract

Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.

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References

  1. ** F, Devesa SS, Chow WH, et al. Cancer incidence trends in urban shanghai, 1972–1994: an update. Int J Cancer 1999; 83:435–440.

    Article  PubMed  CAS  Google Scholar 

  2. Misra S, Chaturvedi A, Misra NC. Penile carcinoma: a challenge for the develo** world. Lancet Oncol 2004; 5:240–247.

    Article  PubMed  Google Scholar 

  3. Pow-Sang MR, Ferreira U, Pow-Sang JM, et al. Epidemiology and natural history of penile cancer. Urology 2010; 76:S2–S6.

    Article  PubMed  Google Scholar 

  4. Pettaway CA, Lynch Jr DF, Davis JW. Tumors of the Penis. In Wein AJ ed, Campbell-Walsh Urology, 9th edn. Chapt 31 SAUNDERS ELSEVIER 2007

  5. Novara G, Galfano A, De Marco V, et al. Prognostic factors in squamous cell carcinoma of the penis. Nat Clin Pract Urol 2007; 4:140–146.

    Article  PubMed  Google Scholar 

  6. Ficarra V, Akduman B, Bouchot O, et al. Prognostic factors in penile cancer. Urology 2010; 76:S66–S73.

    Article  PubMed  Google Scholar 

  7. Protzel C, Alcaraz A, Horenblas S, et al. Lymphadenectomy in the surgical management of penile cancer. Eur Urol 2009; 55:1075–1088.

    Article  PubMed  Google Scholar 

  8. Johnson TV, Hsiao W, Delman KA, et al. Extensive inguinal lymphadenectomy improves overall 5-year survival in penile cancer patients: results from the Surveillance, Epidemiology, and End Results program. Cancer 2010; 116:2960–2966.

    Article  PubMed  Google Scholar 

  9. Pagliaro LC, Williams DL, Daliani D, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 2010; 28:3851–3857.

    Article  PubMed  CAS  Google Scholar 

  10. Bermejo C, Busby JE, Spiess PE, et al. Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 2007; 177:1335–1338.

    Article  PubMed  Google Scholar 

  11. Leijte JA, Kerst JM, Bais E, et al. Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 2007; 52:488–494.

    Article  PubMed  CAS  Google Scholar 

  12. Delacroix SE Jr, Pettaway CA. Therapeutic strategies for advanced penile carcinoma. Curr Opin Support Palliat Care 2010; 4:285–292.

    Article  PubMed  Google Scholar 

  13. Pettaway CA, Pagliaro L, Theodore C, et al. Treatment of visceral, unresectable, or bulky/unresectable regional metastases of penile cancer. Urology 2010; 76:S58–S65.

    Article  PubMed  Google Scholar 

  14. Ravi R. Correlation between the extent of nodal involvement and survival following groin dissection for carcinoma of the penis. Br J Urol 1993; 72:817–819.

    Article  PubMed  CAS  Google Scholar 

  15. Pandey D, Mahajan V, Kannan RR. Prognostic factors in node-positive carcinoma of the penis. J Surg Oncol 2006; 93:133–138.

    Article  PubMed  Google Scholar 

  16. Gospodarowicz MK, O’sullivan B, H. SL. Prognostic Factors in Cancer. 3rd edn: John Wiley & Sons, 2006.

  17. Svatek RS, Munsell M, Kincaid JM, et al. Association between lymph node density and disease specific survival in patients with penile cancer. J Urol 2009; 182:2721–2727.

    Article  PubMed  Google Scholar 

  18. Lont AP, Kroon BK, Gallee MP, et al. Pelvic lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival. J Urol 2007; 177:947–952.

    Article  PubMed  Google Scholar 

  19. Zhu Y, Zhang SL, Ye DW, et al. Predicting pelvic lymph node metastases in penile cancer patients: a comparison of computed tomography, Cloquet’s node, and disease burden of inguinal lymph nodes. Onkologie 2008; 31:37–41.

    Article  PubMed  CAS  Google Scholar 

  20. Leijte JA, Gallee M, Antonini N, et al. Evaluation of current TNM classification of penile carcinoma. J Urol 2008; 180:933–938.

    Article  PubMed  Google Scholar 

  21. Crawshaw JW, Hadway P, Hoffland D, et al. Sentinel lymph node biopsy using dynamic lymphoscintigraphy combined with ultrasound-guided fine needle aspiration in penile carcinoma. Br J Radiol 2009; 82:41–48.

    Article  PubMed  CAS  Google Scholar 

  22. Graafland NM, Moonen LM, van Boven HH, et al. Prognostic Significance of Extranodal Extension in Patients With Pathological Node Positive Penile Carcinoma. J Urol 2010; 184:1347–1353.

    Article  PubMed  Google Scholar 

  23. Lopes A, Hidalgo GS, Kowalski LP, et al. Prognostic factors in carcinoma of the penis: multivariate analysis of 145 patients treated with amputation and lymphadenectomy. J Urol 1996; 156:1637–1642.

    Article  PubMed  CAS  Google Scholar 

  24. Zhu Y, Zhang HL, Yao XD, et al. Development and evaluation of a nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes. J Urol 2010; 184:539–545.

    Article  PubMed  Google Scholar 

  25. Vinh-Hung V, Nguyen NP, Cserni G, et al. Prognostic value of nodal ratios in node-positive breast cancer: a compiled update. Future Oncol 2009; 5:1585–1603.

    Article  PubMed  Google Scholar 

  26. Berger AC, Sigurdson ER, LeVoyer T, et al. Colon cancer survival is associated with decreasing ratio of metastatic to examined lymph nodes. J Clin Oncol 2005; 23:8706–8712.

    Article  PubMed  Google Scholar 

  27. Vinh-Hung V, Verkooijen HM, Fioretta G, et al. Lymph node ratio as an alternative to pN staging in node-positive breast cancer. J Clin Oncol 2009; 27:1062–1068.

    Article  PubMed  Google Scholar 

  28. Fleischmann A, Thalmann GN, Markwalder R, et al. Extracapsular extension of pelvic lymph node metastases from urothelial carcinoma of the bladder is an independent prognostic factor. J Clin Oncol 2005; 23:2358–2365.

    Article  PubMed  Google Scholar 

  29. Brasilino de Carvalho M. Quantitative analysis of the extent of extracapsular invasion and its prognostic significance: a prospective study of 170 cases of carcinoma of the larynx and hypopharynx. Head Neck 1998; 20:16–21.

    Article  PubMed  CAS  Google Scholar 

  30. Myers JN, Greenberg JS, Mo V, et al. Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue. Cancer 2001; 92:3030–3036.

    Article  PubMed  CAS  Google Scholar 

  31. Fons G, Hyde SE, Buist MR, et al. Prognostic value of bilateral positive nodes in squamous cell cancer of the vulva. Int J Gynecol Cancer 2009; 19:1276–1280.

    Article  PubMed  Google Scholar 

  32. Theunissen PH, Bollen EC, Koudstaal J, et al. Intranodal and extranodal tumour growth in early metastasised non-small cell lung cancer: problems in histological diagnosis. J Clin Pathol 1994; 47:920–923.

    Article  PubMed  CAS  Google Scholar 

  33. Lopes A, Bezerra AL, Serrano SV, et al. Iliac nodal metastases from carcinoma of the penis treated surgically. BJU Int 2000; 86:690–693.

    Article  PubMed  CAS  Google Scholar 

  34. Kunos C, Simpkins F, Gibbons H, et al. Radiation therapy compared with pelvic node resection for node-positive vulvar cancer: a randomized controlled trial. Obstet Gynecol 2009; 114:537–546.

    Article  PubMed  Google Scholar 

  35. Homesley HD, Bundy BN, Sedlis A, et al. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol 1986; 68:733–740.

    PubMed  CAS  Google Scholar 

  36. Fleming FJ, Kavanagh D, Crotty TB, et al. Factors affecting metastases to non-sentinel lymph nodes in breast cancer. J Clin Pathol 2004; 57:73–76.

    Article  PubMed  CAS  Google Scholar 

  37. van Deurzen CH, van Hillegersberg R, Hobbelink MG, et al. Predictive value of tumor load in breast cancer sentinel lymph nodes for second echelon lymph node metastases. Cell Oncol 2007; 29:497–505.

    PubMed  Google Scholar 

  38. van Deurzen CH, de Boer M, Monninkhof EM, et al. Non-sentinel lymph node metastases associated with isolated breast cancer cells in the sentinel node. J Natl Cancer Inst 2008; 100:1574–1580.

    Article  PubMed  Google Scholar 

  39. Edge SB, Byrd DR, Carducci MA, et al. AJCC Cancer Staging Manual. 7th edn, New York, NY: Springer, 2009.

    Google Scholar 

  40. Oonk MH, van Hemel BM, Hollema H, et al. Size of sentinel-node metastasis and chances of non-sentinel-node involvement and survival in early stage vulvar cancer: results from GROINSS-V, a multicentre observational study. Lancet Oncol 2010; 11:646–652.

    Article  PubMed  Google Scholar 

  41. Kroon BK, Nieweg OE, van Boven H, et al. Size of metastasis in the sentinel node predicts additional nodal involvement in penile carcinoma. J Urol 2006; 176:105–108.

    Article  PubMed  Google Scholar 

  42. Ivaz S, Ayres BE, Lam W, et al. Does size of sentinel lymph node metastasis in squamous cell carcinoma of the penis predict risk of further nodal disease? 2010 Genitourinary Cancers Symposium 2010: Abs 252.

  43. Leijte JA, Horenblas S. Shortcomings of the current TNM classification for penile carcinoma: time for a change? World J Urol 2009; 27:151–154.

    Article  PubMed  Google Scholar 

  44. AI-Najar AA, van der Horst C, Juenemann KP, et al. External validation of the proposed TNM classification of penile squamous cell carcinoma. Eur Urol Suppl 2009; 8:369.

    Article  Google Scholar 

  45. Leijte JA, Hughes B, Graafland NM, et al. Two-center evaluation of dynamic sentinel node biopsy for squamous cell carcinoma of the penis. J Clin Oncol 2009; 27:3325–3329.

    Article  PubMed  Google Scholar 

  46. Leijte JA, Kroon BK, Valdes Olmos RA, et al. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 2007; 52:170–177.

    Article  PubMed  Google Scholar 

  47. Graafland NM, Valdes Olmos RA, Meinhardt W, et al. Nodal staging in penile carcinoma by dynamic sentinel node biopsy after previous therapeutic primary tumour resection. Eur Urol 2010; 58:748–751.

    Article  PubMed  Google Scholar 

  48. Spiess PE, Hernandez MS, Pettaway CA. Contemporary inguinal lymph node dissection: minimizing complications. World J Urol 2009; 27:205–212.

    Article  PubMed  Google Scholar 

  49. Marconnet L, Rigaud J, Bouchot O. Long-term followup of penile carcinoma with high risk for lymph node invasion treated with inguinal lymphadenectomy. J Urol 2010; 183:2227–2232.

    Article  PubMed  Google Scholar 

  50. Zhu Y, Zhang SL, Ye DW, et al. Prospectively packaged ilioinguinal lymphadenectomy for penile cancer: the disseminative pattern of lymph node metastasis. J Urol 2009; 181:2103–2108.

    Article  PubMed  Google Scholar 

  51. Carthon BC, Pettaway CA, Pagliaro LC, et al. Epidermal growth factor receptor (EGFR) targeted therapy in advanced metastatic squamous cell carcinoma (AMSCC) of the penis: Updates and molecular analyses. J Clin Oncol 2010; 28:e15022.

    Google Scholar 

  52. Zhu Y, Li H, Yao XD, et al. Feasibility and activity of sorafenib and sunitinib in advanced penile cancer: a preliminary report. Urol Int 2010: 85:334–340.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China

    Yao Zhu & Ding-wei Ye

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Yao Zhu & Ding-wei Ye

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  1. Yao Zhu
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  2. Ding-wei Ye
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Correspondence to Ding-wei Ye.

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Zhu, Y., Ye, Dw. Lymph node metastases and prognosis in penile cancer. Chin. J. Cancer Res. 24, 90–96 (2012). https://doi.org/10.1007/s11670-012-0090-2

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  • DOI: https://doi.org/10.1007/s11670-012-0090-2

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