Radiotherapy plus chemotherapy versus chemotherapy alone in penile cancer patients with extracapsular nodal extension after inguinal lymph node surgery: a multi-institutional study
Radiotherapy plus chemotherapy versus chemotherapy alone in penile cancer patients with extracapsular nodal extension after inguinal lymph node surgery: a multi-institutional study
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腹股沟淋巴结手术后出现囊外淋巴结扩展的阴茎癌患者放疗加化疗与单独化疗的比较：一项多机构研究
DOI：
10.1007/s00345-020-03179-y
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发表时间：
2020-04
影响因子：
3.4
通讯作者：
Zhou Fang-Jian
中科院分区：
文献类型：
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作者：
Li Zai-Shang;Li Xue-Ying;Wang Bin;Chen Peng;Li Xiang;Augusto Ornellas Antonio;Qin Zi-Ke;Liu Zhuo-Wei;Li Yong-Hong;Han Hui;Zhou Fang-Jian
目的由于缺乏证据，一般不推荐采用辅助放疗加化疗治疗阴茎癌淋巴结疾病。本研究的目的是确定阴茎癌腹股沟手术后使用辅助放疗的益处。方法从2003年4月至2015年4月共获得9个中心的多机构数据并进行回顾性分析。包括腹股沟手术后接受辅助治疗的囊外淋巴结扩展的 pN3 患者。使用 Kaplan-Meier 方法估计癌症特异性生存率 (CSS)。采用Cox比例风险模型进行多变量分析。结果共有93例pN3患者符合纳入标准。在研究期间，其中32名（34.4％）和61名（65.6％）患者接受了辅助放疗加化疗（AR + AC）或单独辅助化疗（AC）。所有患者的 CSS 中位数为 12.0 个月（四分位数范围 [IQR] 7.5–16.5）。 Kaplan-Meier 估计的 AR + AC 组 (28.5%) 的 3 年 CSS 发生率明显长于 AC 组 (16.2%) (p= 0.036)。 AC + AR 与 CSS 改善 7.7 个月相关（17.7 [IQR 3.8–31.6] 与 10.0 [IQR 6.6–13.4] 个月）。在Cox回归分析中，AR + AC是CSS的独立预测因子[模型a：HR 0.486（95% CI 0.258–0.916），模型b：HR 0.527（95% CI 0.286–0.972）]。结论综上所述，AR + AC与显示囊外淋巴结的阴茎癌患者的CCS改善相关腹股沟手术后延长。这一假设还需要进一步证实。
PurposeBecause there is a lack of evidence, it is not generally recommended to use adjuvant radiotherapy plus chemotherapy to treat lymph node disease in penile cancer. The aim of this study was to determine the benefit of using adjuvant radiotherapy after inguinal surgery for penile cancer.MethodsMulti-institutional data were obtained from a total of nine centers from April 2003 to April 2015 and retrospectively analyzed. pN3 patients with an extracapsular nodal extension who received adjuvant therapy after inguinal surgery were included. Cancer-specific survival (CSS) was estimated using the Kaplan–Meier method. The multivariate analysis was performed using a Cox proportional hazards model.ResultsA total of 93 pN3 patients met the inclusion criteria. During the study period, 32 (34.4%) and 61 (65.6%) of these patients received adjuvant radiotherapy plus chemotherapy (AR + AC) or adjuvant chemotherapy alone (AC). The median CSS in all patients was 12.0 months (interquartile range [IQR] 7.5–16.5). The Kaplan–Meier estimated 3-year CSS rate was significantly longer in the AR + AC group (28.5%) than the AC group (16.2%) (p= 0.036). AC + AR was associated with an improvement in CSS by 7.7 months (17.7 [IQR 3.8–31.6] vs. 10.0 [IQR 6.6–13.4] months). In the Cox regression analysis, AR + AC was an independent predictor of CSS [model a: HR 0.486 (95% CI 0.258–0.916), model b: HR 0.527 (95% CI 0.286–0.972)].ConclusionIn conclusions, AR + AC was associated with improved CCS in patients with penile cancer who displayed an extracapsular nodal extension after inguinal surgery. This hypothesis requires further confirmation.
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DOI：
10.1007/978-3-030-52021-2_25
发表时间：
2020-09
期刊：
Chemotherapy and Immunotherapy in Urologic Oncology
影响因子：
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作者：
J. Mark;D. Squadrito
通讯作者：
J. Mark;D. Squadrito
影响因子：
23.4
作者：
O. Hakenberg;C. Protzel
通讯作者：
O. Hakenberg;C. Protzel
影响因子：
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作者：
Choo, Richard;Nehra, Avinash;Karnes, R. Jeffrey
通讯作者：
Karnes, R. Jeffrey
影响因子：
6.6
作者：
Lughezzani, Giovanni;Catanzaro, Mario;Nicolai, Nicola
通讯作者：
Nicolai, Nicola
影响因子：
81.5
作者：
Eleni Anastasiadis;Nicholas A. Watkin
通讯作者：
Eleni Anastasiadis;Nicholas A. Watkin