Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy.
BACKGROUND
The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. Physical exam and image exams are not adequate to evaluate inguinal lymph nodes and many patients are submitted to non-therapeutic lymphadenectomies. However, it is known that not all patients with clinically or histologically negative inguinal lymph nodes evolve favorably.


METHODS
the authors evaluated the clinical and pathologic characteristics of 163 patients with penile carcinoma and clinically negative inguinal lymph nodes followed for three or more years and their impact on global survival (GS) and cancer-specific survival (CSS) in the 10-year follow-up. Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019).


CONCLUSIONS
high histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years.
Departamento de Urologia, Hospital Universitário - Universidade Federal do Piauí, Brasil.
Giuliano Amorim
GA
Aita
Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil.
Stênio de Cássio
SC
Zequi
Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil.
Walter Henriques da
WH
Costa
Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil.
Gustavo Cardoso
GC
Guimarães
Departamento de Patologia, AC Camargo Cancer Center, SP, Brasil.
Fernando Augusto
FA
Soares
Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil.
Thais Safranov
TS
Giuliangelis
D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012307:Risk Factors
Penile Neoplasms; Penis; Prognosis