Abstract
Background: To determine independent predictors of inguinal lymph node(ILN) metastasis in patients with penile-cancer.Patients and methods: We retrospectively analyzed all patients with penile-cancer undergoing surgery at our medical center in ten years(N=157). Using univariate and multivariate logistic-regression models, we assessed associations between the following factors: age, medical-history, phimosis, onset-time, number and maximum diameter of involved ILNs, pathological T stage, degree of tumor differentiation and/or cornification, lymphatic vascular infiltration(LVI), nerve infiltration, and ILN metastases. Interaction and stratified analyses were then used to assess age, phimosis, onset-time, number of ILNs, cornification, and nerve infiltration.Results: Ultimately, 110 patients were included. Multiple logistic-regression analysis showed that the following factors were significantly correlated with ILN metastasis: maximum diameter of enlarged ILNs, T stage, pathological differentiation, and LVI. Among patients with a maximum ILN diameter of ≥1.5 cm, 50%(19/38) had LNM(HR=2.3, 95%CI: 1.0–5.1), whereas only 30.6%(22/72) of patients with a maximum ILN diameter <1.5 cm showed LNM. Among 44 patients with stage Ta/T1, 10(22.7%) showed ILN metastases, while 31 of 66(47.0%) patients with stage T2 showed ILN metastases(HR=3.0, 95%CI: 1.3–7.1). Among 40 patients with highly differentiated penile-cancer, eight(20%) showed ILN metastasis, while 33 of 70(47.1%) patients with low-to-middle differentiation showed ILN metastases(HR=3.6, 95%CI: 1.4–8.8). In the LVI-free group, the rate of LNM was 33.3%(32/96), whereas it was 64.3%(9/14) in the LVI group(HR=3.6, 95%CI: 1.1–11.6). Conclusion: Our single-center results suggested that maximum ILN diameter, pathological T stage, pathological differentiation, and LVI were independent risk factors for ILN metastases.
Analysis of the Related Risk Factors of Inguinal Lymph Node Metastasis in Patients with Penile Cancer: A Cross-sectional Study
