Proposal for reclassification of N staging system in penile cancer patients, based on number of positive lymph nodes

• DOI: 10.1111/cas.13484
• Publication Date: 2017-12-29T06:16:42Z
• Authors: Zhiyong Li; Shengjie Guo; Zhiming Wu; Hui Han; Zaishang Li; Yanjun Wang; Jieping Chen; Chuangzhong Deng; Zike Qin; Zhuowei Liu; Yonghong Li; Dong Chen; Fangjian Zhou; Kai Yao
• Keywords: Concordance

In the present study, we aim to compare rationality of proposed N classification based on number metastatic lymph nodes (LNs) with current one. A total 509 penile cancer patients at our institute were analyzed. Univariable and multivariable statistical analyses used assess cancer-specific survival (CSS) in 2 staging systems. Harrell's concordance index was applied evaluate predictive accuracy predicting CSS. We propose a new classification: pN1 (metastasis 1-2 regional LNs), pN2 3 LNs, or fewer extranodal extension), pN3 4 more LNs). According classification, 5-year CSS pN1, 85.8%, 39.0%, 19.7%; 79.8%, 39.3% 15.3%, which almost all showed significant difference (P < .001, P = .259) .001). Multivariable 76.48% 70.92% (5.56% gain; With model clinical features, both (hazard ratio [HR], 7.761, 10.612; .001) stages (HR, 3.792, 3.971; exhibited independent effects survival. The is superior one, simpler provides accurate prognosis.