title: Risk factors for lymph node metastasis in clinically node-negative penile cancer patients.
abstract: OBJECTIVE
  To analyze the effects of pathological T stage, grade, extent of surgery for primary tumor, and age group on the risk of developing lymph node metastasis in clinically node-negative penile cancer patients.
  
  
  METHODS
  We performed a retrospective analysis of 200 clinically node-negative penile cancer patients who were kept under surveillance, after treatment of the primary tumor in our institution. The primary outcome parameter was cytologically or histologically proven lymph node metastasis. Logistic regression analysis was used to compute odds ratios in univariate and multivariate settings.
  
  
  RESULTS
  Lymph node metastasis occurred in 31 patients at a median time of three months. Histological grade 3 and grade 2 tumors had a statistically significant increased odds ratio for lymph node metastasis, (7.1[P < 0.001] and 2.7 [P = 0.04], respectively), compared with grade 1 tumors. Although increasing pT stage was associated with increasing odds ratios, the differences were not statistically significant. Nor did the extent of surgery of the primary tumor or the age group significantly influence the risk of developing lymph node metastasis.
  
  
  CONCLUSIONS
  Histological grade is the most significant parameter influencing the risk of lymph node metastasis in clinically node-negative penile cancer patients on surveillance. Patients with grade 3 and grade 2 tumors may benefit from elective inguinal lymphadenectomy.
authors.affiliation: Department of Surgical Oncology, Cancer Institute (WIA), Annexe Campus, Chennai, India. docaravind@gmail.com
authors.forename: Aravind
authors.initials: A
authors.lastname: Ramkumar
authors.forename: Ramakrishnan Ayloor
authors.initials: RA
authors.lastname: Seshadri
authors.forename: Kathiresan
authors.initials: K
authors.lastname: Narayanaswamy
authors.forename: Satheesan
authors.initials: S
authors.lastname: Balasubramanian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors