title: The risk factors for the presence of pelvic lymph node metastasis in penile squamous cell carcinoma patients with inguinal lymph node dissection.
abstract: OBJECTIVE
  To evaluate factors in penile squamous cell carcinoma predictive of pelvic lymph node metastasis and survival.
  
  
  METHODS
  Data were collected and analyzed retrospectively in 146 patients with squamous cell carcinoma of penis who underwent bilateral inguinal lymph node dissection in our center between January 1998 and April 2011. Variables recorded included serum squamous cell carcinoma antigen, primary tumor p53 immunoreactivity, histological grade, pathological tumor stage, lymphatic or vascular invasion, absent/unilateral or bilateral inguinal lymph node involvement, number of metastatic inguinal lymph nodes, presence of extracapsular growth and lymph node density.
  
  
  RESULTS
  Seventy patients had inguinal lymph node metastasis (LNM). Of these, 33 (47.1%) had pelvic LNM. Primary tumor strong p53 expression, lymphatic or vascular invasion, involvement of more than two inguinal lymph nodes and 30% or greater lymph node density were significant predictors of pelvic LNM. Primary tumor strong p53 expression (odds ratio [OR] 5.997, 95% confidence intervals [CI] 1.615-22.275), presence of extracapsular growth (OR 2.209, 95% CI 1.166-4.184), involvement of more than two inguinal lymph nodes (OR 2.494, 95% CI 1.086-5.728) and pelvic lymph node involvement (OR 18.206, 95% CI 6.807-48.696) were independent prognostic factors for overall survival.
  
  
  CONCLUSIONS
  Primary tumor expression of p53, lymphatic or vascular invasion, number of metastatic inguinal lymph nodes and lymph node density were all predictors of pathologic pelvic lymph node involvement. Patients with pelvic LNM had an adverse prognosis, with a 3-year overall survival rate of approximately 12.1%. Pelvic lymph node dissection should be considered in these cases.
authors: State Key Laboratory of Oncology in South China, Guangzhou, 510060, Guangdong, People's Republic of China.
authors: Jian-Ye
authors: JY
authors: Liu
authors: Yong-Hong
authors: YH
authors: Li
authors: Zhi-Ling
authors: ZL
authors: Zhang
authors: Kai
authors: K
authors: Yao
authors: Yun-Lin
authors: YL
authors: Ye
authors: Dan
authors: D
authors: Xie
authors: Hui
authors: H
authors: Han
authors: Zhou-Wei
authors: ZW
authors: Liu
authors: Zi-Ke
authors: ZK
authors: Qin
authors: Fang-Jian
authors: FJ
authors: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D002681:China; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000601:surgery*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010388:Pelvis; D010412:Penile Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000097:blood
chemical_list: D000951:Antigens, Neoplasm; D016159:Tumor Suppressor Protein p53