title: Prognostic factors in patients with penile carcinoma and inguinal lymph node metastasis.
abstract: OBJECTIVE
  To identify prognostic factors in patients with penile carcinoma and confirmed lymph node metastasis.
  
  
  METHODS
  Patients were selected from a historical series of patients with penile carcinoma. An experienced pathologist reviewed all cases. Information regarding the total number of lymph nodes excised, the number of positive lymph nodes and the presence of extranodal extension were used. Lymph node ratio was categorized as <0.15 and >0.15.
  
  
  RESULTS
  The 5-year recurrence-free survival and disease-specific survival rates were 55.3% and 64.1%, respectively. Lymphovascular invasion, lymph node ratio and pN status influenced survival rates in univariate analysis. Lymphovascular invasion and lymph node ratio remained as independent predictors of disease-specific survival and recurrence-free survival in the multivariate analysis. A risk stratification of death and tumor recurrence was observed when patients were grouped into three categories: absence of risk factors; the presence of one risk factor; and the presence of two or more risk factors.
  
  
  CONCLUSIONS
  The presence of one or more of the following parameters is correlated with a significantly higher risk of death and tumor recurrence in patients with penile carcinoma and inguinal lymph node metastasis: extranodal extension, lymph node ratio >0.15 and lymphovascular invasion.
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Walter Henriques
authors.initials: WH
authors.lastname: da Costa
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Renato Almeida
authors.initials: RA
authors.lastname: Rosa de Oliveira
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Thiago Borges
authors.initials: TB
authors.lastname: Santana
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Bruno Santos
authors.initials: BS
authors.lastname: Benigno
authors.affiliation: Pathology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Isabela Werneck
authors.initials: IW
authors.lastname: da Cunha
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Stênio
authors.initials: S
authors.lastname: de Cássio Zequi
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Gustavo Cardoso
authors.initials: GC
authors.lastname: Guimaraes
authors.affiliation: Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
authors.forename: Ademar
authors.initials: A
authors.lastname: Lopes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010412:Penile Neoplasms / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
keywords: lymph node; metastasis; penile cancer; penile carcinoma; prognosis