Comparison of Early Inguinal Lymph Node Dissection and Neoadjuvant Chemotherapy in Penile Cancer Patient with Bulky Nodal Metastasis: A Cohort Study
Urology Journal,
Vol. 21 No. 01 (2024),
28 February 2024
,
Page 47-51
https://doi.org/10.22037/uj.v20i.7448
Abstract
Purpose: Penile cancer is a rare malignancy, where extranodal extension in inguinal or pelvic lymph nodes is
associated with decreased 5-year cancer-survival rate in this study, we try to assess survival and quality of life in a
penile cancer patient with bulky lymph node.
Methods: We retrospectively reviewed data from penile cancer patients with bulky lymph nodes who underwent
treatment between July 2016 and July 2021 at tertiary referral hospital care. The inclusion criteria (age >18 yr, histologically proven penile cancer, and completion of last treatment 6 months prior to this study) yielded a cohort of 20 eligible penile cancer patients with bulky lymph nodes (> 4 cm/bilateral mobile/unilateral fixed). Only patients
who had completed therapy at least 6 months prior to the study were included. After obtaining consent, they were
asked to complete the EORTC QLQ-C30 questionnaire to evaluate the patient's quality of life.
Results: Out of 20 patients, 5 patients underwent direct ILND and 15 patients underwent chemotherapy. Median
follow-up after primary diagnosis was 114+32 months in patients with early ILND and 52+11 months in patients
who underwent delayed lymph node dissection. Out of 5 patients who underwent early ILND, all of them survived
during follow-up, and achieved cancer-free status without residual tumor and with excellent functional outcomes
(Karnofsky 90). There was no significant difference in social function (p-value = 0.551), physical function (p-value
= 0.272), role function (p-value = 0.546), emotional function (p-value = 0.551), cognitive function (p-value =
0.453), and global health status (p-value = 0.893) between patient which treated with early ILND and Neoadjuvant
Chemotherapy. However, patients who underwent early ILND showed a relatively better clinical outcome.
Conclusion: Early ILND followed by adjuvant chemotherapy for penile cancer with palpable lymph nodes is more
favourable than neoadjuvant TIP chemotherapy.
- Keywords: Penile cancer, lymph node, dissection, neoadjuvant chemotherapy, bulky nodal
How to Cite
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