Characteristic of penile cancer and prognostic factors of inguinal and pelvic lymph node involvement

BACKGROUND: Penile cancer is a rare malignancy which inguinal and pelvic lymph node involvement plays a major role in patients’ survival. The prognosis of patients with lymph node metastasis is poorer. OBJECTIVE: The objective of the study was to evaluate the prognostic factors for inguinal lymph node and pelvic lymph node involvement. MATERIALS AND METHODS: This was a retrospective analytic study of medical records between January 2010 and December 2020. RESULTS: Thirty-nine patients were diagnosed with penile cancer, median age of 59 ± 14.898 (range: 32–86 years) were included in the analysis. Twenty-eight patients underwent inguinal lymph node dissection, 13 patients had inguinal lymph node metastasis (46.4%), 8 patients underwent pelvic lymph node dissection, and 5 patients had pelvic lymph node metastasis (62.5%). Inguinal lymph node metastasis was associated with tumor grading (odds ratio [OR]: 2.92, confidence interval [CI]: 0.123–0.704), lymphovascular invasion (LVI) (OR: 5.182, CI: 0.430–0.996), perineural invasion (PNI) (OR: 3.687, CI: 0.277–0.975), and fixation of inguinal node (OR: 2.463, CI: 0.078–1.195). Pelvic lymph node metastasis was associated with tumor grading (OR: 2.619, CI: 0.033–0.967). CONCLUSION: Grading, LVI and PNI of primary tumor, and fixation of inguinal node are significantly associated with inguinal lymph node metastasis. While primary tumor grading is significantly associated with pelvic lymph node metastasis. These factors are associated with poorer prognosis.