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Lymphovascular and perineural invasion are risk factors for inguinal lymph node metastases in men with T1G2 penile cancer

  • Original Article – Cancer Research
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Abstract

Purpose

To analyse the risk of inguinal lymph node (ILN) metastases in T1G2 penile cancer stratified by lymphovascular invasion (LVI), perineural invasion (PNI) and tumour size.

Methods

Retrospective study of men with localised T1G2 penile cancer with non-palpable lymph nodes and no local recurrence during follow-up at six European institutional high-volume centres was performed. ILN involvement was defined as cancer detected during ultrasound-guided fine-needle aspiration cytology, core needle biopsy, dynamic sentinel lymph node biopsy, ILN dissection or inguinal recurrence during follow-up. Uni- and multivariable logistic regression analyses were performed.

Results

In the cohort of 554 men with T1G2 penile cancer, from 6 European institutions, ILN metastases were observed in 46/554 men (8%, 95% confidence interval (CI) 6–11%). Men with both, LVI- and PNI- primary cancers had the lowest risk of ILN involvement (6%) whereas men with LVI + or PNI + showed ILN metastases in 22% and 30%. In multivariable regression, men with LVI + or PNI + had higher odds for ILN metastases compared to men with LVI- and PNI- (OR 3.9, 95% CI 1.6–9.0, p value < 0.01) Tumour size was not associated with ILN risk (OR 1.01 95% CI 0.99–1.04, p = 0.17).

Conclusion

Approximately, one out of ten men with T1G2 overall and one out of four men with either LVI + or PNI + still have ILN metastases despite being clinically node negative. Therefore, invasive ILN staging should strongly be recommended in T1G2 with LVI + or PNI + but importantly, must be discussed in patients with T1G2 with LVI- or PNI-.

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Acknowledgements

Asif Muneer is supported by the NIHR Biomedical Research Centre UCLH. The authors declare no conflict of interests.

Funding

Asif Muneer is supported by the NIHR Biomedical Research Centre UCLH.

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Authors and Affiliations

  1. Department of Urology, The Christie NHS Foundation Trust, Manchester, UK

    Christian D. Fankhauser, Allaudin Issa, Esther W. C. Lee, Maurice Lau, Arie Parnham & Vijay Sangar

  2. Department of Urology, Luzerner Kantonsspital, University of Lucerne, Lucerne, Switzerland

    Christian D. Fankhauser & Luca Antonelli

  3. University of Zurich, Zurich, Switzerland

    Christian D. Fankhauser

  4. Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    Hielke M. de Vries & Oscar R. Brouwer

  5. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Hielke M. de Vries & Oscar R. Brouwer

  6. Department of Urology, University Hospitals Leuven, Leuven, Belgium

    Eduard Roussel & Maarten Albersen

  7. Department of Urology, Aarhus University Hospital, Aarhus, Denmark

    Jakob Kristian Jakobsen

  8. NIHR Biomedical Research Centre, University College London Hospital, London, UK

    Nicolo Schifano, Hussain Alnajjar, Fabio Castiglione & Asif Muneer

  9. Department of Urology, University College London Hospital, London, UK

    Nicolo Schifano, Hussain Alnajjar, Fabio Castiglione & Asif Muneer

  10. Division of Surgery and Interventional Science, UCL, London, UK

    Nicolo Schifano, Hussain Alnajjar, Fabio Castiglione & Asif Muneer

  11. Department of Urology, Policlinico Umberto I, Rome, Italy

    Luca Antonelli

  12. Department of Pathology, The Christie NHS Foundation Trust, Manchester, UK

    Pedro Oliveira

  13. Department of Urology, St George’s Hospital, London, UK

    Nicholas A. Watkin & Ben E. Ayres

  14. Manchester Academic Health Sciences Centre, Manchester, UK

    Vijay Sangar

  15. Luzerner Kantonsspital, Luzern, Switzerland

    Christian D. Fankhauser

Authors
  1. Christian D. Fankhauser
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  2. Hielke M. de Vries
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  3. Eduard Roussel
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  6. Esther W. C. Lee
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  12. Maurice Lau
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  16. Asif Muneer
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  18. Oscar R. Brouwer
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  19. Vijay Sangar
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Contributions

Conceptualisation: CF and VS. Methodology: CDF and HMdV. Formal analysis: CF. Resources: ER, JKJ, AI, EWCL, NS, HA, FC, PO, ML, AP, MA, NAW, AM, BEA, and ORB. Data curation: ER, JKJ, AI, EWCL, NS, HA, FC, PO, ML, AP, MA, NAW, AM, BEA, and ORB. Writing—original draft: CF, VS, MA, AM, BEA, ORB, AP, and MA. Writing—review and editing: ER, JKJ, AI, EWCL, NS, HA, FC, PO, ML, NAW, AM, BEA, ORB, and LA. Visualisation: CF. Supervision: NAW, AM, BEA, and ORB. Project administration: CF.

Corresponding author

Correspondence to Christian D. Fankhauser.

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Conflict of interest

The authors declare no conflict of interests. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Research involving human and animal participants

This article does not contain any studies/experiments with human participants or animals performed by any of the authors.

Informed consent

All person gave their informed consent to use their data (deidentified) for this retrospective study.

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Cite this article

Fankhauser, C.D., de Vries, H.M., Roussel, E. et al. Lymphovascular and perineural invasion are risk factors for inguinal lymph node metastases in men with T1G2 penile cancer. J Cancer Res Clin Oncol 148, 2231–2234 (2022). https://doi.org/10.1007/s00432-022-04012-2

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  • DOI: https://doi.org/10.1007/s00432-022-04012-2

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