title: Nomogram predictive of pathological inguinal lymph node involvement in patients with squamous cell carcinoma of the penis.
abstract: OBJECTIVE
  In penile cancer the therapeutic benefits of early inguinal lymphadenectomy must be counterbalanced by the high rates of morbidity, postoperative complications and mortality. A relevant aim is optimizing the selection of the patients who could really have the highest survival advantage from inguinal lymphadenectomy, limiting the cases in which this surgery might be considered over treatment with a risk of severe complications. We generated a nomogram estimating the risk of pathological inguinal lymph node involvement according to clinical lymph node stage and pathological findings of the primary tumor.
  
  
  METHODS
  We retrospectively collected the clinical and pathological data of 175 patients who had undergone surgical therapy for squamous cell carcinoma of the penis from 1980 to 2002 at 11 urological centers in northeastern Italy. A logistic regression model was used to construct the nomogram.
  
  
  RESULTS
  The presence of palpable groin lymph nodes and the histological findings of vascular and/or lymphatic embolization were important predictors of metastatic inguinal lymph node involvement. The nomogram predicting the risk of metastatic lymph node involvement showed a good concordance index (0.876) and good calibration.
  
  
  CONCLUSIONS
  The clinical stage of groin lymph nodes and pathological findings of penectomy specimens allowed us to generate a nomogram to predict the probability of metastatic lymph node involvement in patients with squamous cell carcinoma of the penis. The statistical model showed an excellent ability to identify the patients with lymph node metastases and good calibration.
authors.affiliation: Department of Urology, University of Verona, Verona, Italy. vincenzo.ficarra@univr.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
authors.forename: Filiberto
authors.initials: F
authors.lastname: Zattoni
authors.forename: Walter
authors.initials: W
authors.lastname: Artibani
authors.forename: Andrea
authors.initials: A
authors.lastname: Fandella
authors.forename: Guido
authors.initials: G
authors.lastname: Martignoni
authors.forename: Giacomo
authors.initials: G
authors.lastname: Novara
authors.forename: Tommaso Prayer
authors.initials: TP
authors.lastname: Galetti
authors.forename: Tiziano
authors.initials: T
authors.lastname: Zambolin
authors.forename: Michael W
authors.initials: MW
authors.lastname: Kattan
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000556:secondary*; D006801:Humans; D007264:Inguinal Canal; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D010412:Penile Neoplasms / Q000473:pathology*; D011379:Prognosis