The importance of extranodal extension in penile cancer: a meta-analysis.
The importance of extranodal extension in penile cancer: a meta-analysis.
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阴茎癌结外扩展的重要性：荟萃分析
DOI：
10.1186/s12885-015-1834-4
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发表时间：
2015-10-28
期刊：
影响因子：
3.8
通讯作者：
Zhou FJ
中科院分区：
文献类型：
--
作者：
Zhang ZL;Yu CP;Liu ZW;Velet L;Li YH;Jiang LJ;Zhou FJ
结外延伸（ENE）在阴茎癌中的作用是有争议的，尚未得到很好的研究。本研究的目的是探讨ENE在预测阴茎癌患者预后和盆腔淋巴结转移（PLNM）的重要性。方法在Medline、Embase、Cochrane Library和Scopus数据库中检索相关研究。从纳入的研究中直接提取或间接估计风险比（HR）和优势比（OR）。结果本荟萃分析共纳入10项研究，1142例患者。ENE患者的肿瘤特异性生存期（CSS） （HR = 1.90, 95%可信区间[CI] = 1.35 ~ 2.67，P= 0.0002）和总生存期（HR = 4.04, 95% CI = 1.02 ~ 16.1，P= 0.05）均低于无ENE患者。进一步的亚组分析显示，ENE对阴茎癌患者CSS的预测价值与研究的原产国无关，但在随访时间较短的亚组（<36个月，P= 0.38）中没有统计学意义。ENE患者出现PLNM的发生率也较高（OR = 4.95, 95% CI = 2.58-9.49，P< 0.001）。一项分层分析表明，ENE对PLNM的预测作用仅在样本量较大的研究中被检测到（约100例）。正如Begg和Egger的检验所表明的那样，没有观察到显著的发表偏倚。结论seni与阴茎癌患者预后差、PLNM发生风险高相关。由于本荟萃分析纳入的研究数量有限，需要一项大规模、设计良好的研究来验证我们的结果。
BackgroundThe role of extranodal extension (ENE) in penile cancer is controversial and has not been well studied. The aim of this study was to investigate the importance of ENE in predicting prognosis and presence of pelvic lymph node metastasis (PLNM) in penile cancer patients.MethodsWe searched related studies in Medline, Embase, Cochrane Library, and Scopus database. Hazard ratio (HR) and odds ratio (OR) were directly extracted or indirectly estimated from the included studies.ResultsA total of ten studies with 1,142 patients were included in this meta-analysis. Patients with ENE showed a worse cancer-specific survival (CSS) (HR = 1.90, 95 % confidence interval [CI] = 1.35–2.67,P= 0.0002) and overall survival (HR = 4.04, 95 % CI = 1.02–16.1,P= 0.05) than those without ENE. Further subgroup analysis revealed that the predictive value of ENE for CSS in penile cancer patients was significant regardless of the study’s country of origin, but not in the subgroup with shorter follow-up time (<36 months,P= 0.38). Patients with ENE also showed a higher incidence of presenting with PLNM (OR = 4.95, 95 % CI = 2.58–9.49,P< 0.001). A stratified analysis demonstrated that the predictive role of ENE for PLNM was only detected in studies with a larger sample size (> 100 cases). No significant publication bias was observed, as suggested by Begg’s and Egger’s tests.ConclusionsENE is associated with worse prognosis and high risk of PLNM in penile cancer patients. Due to the limited number of studies included in this meta-analysis, a large-scale, well-designed study will be required to verify our results.