Abstract

Introduction: Penile carcinoma is a devastating urological neoplasm in which the most assertive prognostic variable is the presence of lymph node involvement. Multiple studies in the current literature have shown that the number of positive lymph nodes predict recurrence free survival (RFS) and overall survival (OS). The objective of this present retrospective analysis is to authenticate the use of LND as a predictor of RFS and OS after ILND. Methods: Our institutional penile cancer database was analyzed for patients who underwent ILND from January 2000 to May 2008. Survival analysis was performed using the Kaplan- Meier method to determine RFS and OS. Two-sided p values lt;0.05 were considered significant. Results: Patients with complete follow up (n=33) were analyzed for clinico-pathological characteristics. LND#x2265;40% was significantly predictive of poor recurrence free survival (Mantle Cox value: 13.609, p=.0005). RFS was significantly lower for patients with LND#x2265;40% (mean survival: 46.22 month vs. 85.79 months, p=.001). Likewise, overall survival was lower in patients with LND#x2265;40% but did not reach significant level (mean survival: 72.48 month vs. 85.30 months, p=.246). Conclusion: In multivariate Cox regression model continuously coded variables age (omnibus coefficient (OC) value: 1.108, p=.041), no. of positive lymph nodes removed (OC value: 3.681, p=.023), total no. of lymph nodes removed (OC value: 0.438, p=.014) were significant predictors of RFS but not OS in cases with LND#x2265;40%. Recent developments in penile cancer may alter the prognostic significance of our LND cutoff of 40%.