Is there any benefit in adding postoperative adjuvan concurrent radiotherapy and chemotherapy for penile cancer with regional lymph node metastasis?
Is there any benefit in adding postoperative adjuvan concurrent radiotherapy and chemotherapy for penile cancer with regional lymph node metastasis?
复制标题
DOI：
10.23736/s0393-2249.19.03387-3
复制
发表时间：
2020-08-01
影响因子：
--
通讯作者：
Karnes, R. Jeffrey
中科院分区：
文献类型：
--
作者：
Choo, Richard;Nehra, Avinash;Karnes, R. Jeffrey
背景技术背景：本研究的目的是评估是否有任何好处，增加术后辅助同步放疗和化疗（RT-CHT）的阴茎癌区域淋巴结转移（RLNM.METHODS）：一个单一的机构，回顾性研究，共23例患者与RLNM阴茎鳞状细胞癌。所有患者均接受了原发性肿瘤和RLNM的明确手术干预。其中，11例患者在术后3个月内接受了辅助同步RT和CHT（RT-CHT组），而12例患者未接受额外治疗（监测组）。采用Kaplan-Meier法计算总生存期。使用对数秩检验检验两组之间的生存差异。一个潜在的预后因素生存进行了评估，使用单变量Cox比例风险model.RESULTS：中位随访为整个组为15.8个月（17.1个月的RT-CHT组和10.7个月的监督组）。RT-CHT组1年和2年的总生存率分别为54.5%和27.2%，而监测组为57.1%和28.4%（对数秩=0.68）。在单因素分析中，受累淋巴结数量和pN 3疾病的存在与预后不良相关（分别为P>0.001和P=0.049）。与监测组相比，RT-CHT组有更广泛的RLNM，阳性淋巴结的中位数更高（5 vs. 3），pN 3疾病更多（72.7% vs. 16.7%）。RT-CHT组需要住院治疗的并发症发生率较高（63.6%对16.6%; P=0.02），全身并发症发生率也较高（34.7%对0%; P
BACKGROUND: The aim of this study was to evaluate whether there is any benefit in adding postoperative adjuvant concurrent radiotherapy and chemotherapy (RT-CHT) for penile cancer with regional lymph node metastasis (RLNM).METHODS: A single institution, retrospective study was conducted for a total of 23 patients with RLNM from penile squamous cell carcinoma. All underwent a definitive surgical intervention for both primary tumor and RLNM. Of these, 11 patients received adjuvant concurrent RT and CHT within 3 months after surgery (RT-CHT group), while 12 patients received no additional treatment (Surveillance Group). Overall survival was calculated with the Kaplan-Meier method. The difference in survival between the two groups was tested using the log-rank test. A potential prognostic factor for survival was evaluated using a univariate Cox-proportional hazards model.RESULTS: Median follow-up for the entire group was 15.8 months (17.1 months for the RT-CHT group and 10.7 months for the Surveillance Group). Overall survival at 1 and 2 years were 54.5% and 27.2%, respectively, for the RT-CHT Group, compared to 57.1% and 28.4% for the Surveillance Group (log-rank=0.68). On a univariate analysis, the number of involved lymph nodes and the presence of pN3 disease were associated with poor prognosis (P>0.001 and P=0.049, respectively). The RT-CHT Group had more extensive RLNM with a higher median number of positive nodes (5 vs. 3) and more pN3 disease (72.7% vs. 16.7%) than the Surveillance Group. The rate of complications requiring hospitalization was higher in the RT-CHT Group (63.6% vs. 16.6%; P=0.02), as was the rate of systemic complications (34.7% vs. 0%; P