Combined Reporting of Surgical Quality and Cancer Control after Surgical Treatment for Penile Tumors with Inguinal Lymph Node Dissection : The Tetrafecta Achievement
Brassetti, Aldo (IRCCS "Regina Elena" National Cancer Institute)
Anceschi, Umberto (IRCCS "Regina Elena" National Cancer Institute)
Cozzi, Gabriele (European Institute of Oncology)
Chavarriaga, Julian (Pontificia Universidad Javeriana)
Gavrilov, Pavel (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Gaya Sopena, Josep Maria (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Bove, Alfredo Maria (IRCCS "Regina Elena" National Cancer Institute)
Prata, Francesco (IRCCS "Regina Elena" National Cancer Institute)
Ferriero, Mariaconsiglia (IRCCS "Regina Elena" National Cancer Institute)
Mastroianni, Riccardo (IRCCS "Regina Elena" National Cancer Institute)
Misuraca, Leonardo (IRCCS "Regina Elena" National Cancer Institute)
Tuderti, Gabriele (IRCCS "Regina Elena" National Cancer Institute)
Torregiani, Giulia (IRCCS "Regina Elena" National Cancer Institute)
Covotta, Marco (IRCCS "Regina Elena" National Cancer Institute)
Camacho, Diego (Instituto Nacional de Cancerologia)
Musi, Gennaro (European Institute of Oncology)
Varela, Rodolfo (Instituto Nacional de Cancerologia)
Breda, Alberto (Institut d'Investigació Biomèdica Sant Pau)
De Cobelli, Ottavio (European Institute of Oncology)
Simone, Giuseppe (IRCCS "Regina Elena" National Cancer Institute (Roma, Itàlia))
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	To optimize results reporting after penile cancer (PC) surgery, we proposed a Tetrafecta and assessed its ability to predict overall survival (OS) probabilities. A purpose-built multicenter, multi-national database was queried for stage I-IIIB PC, requiring inguinal lymphadenectomy (ILND), from 2015 onwards. Kaplan-Meier (KM) method assessed differences in OS between patients achieving Tetrafecta or not. Univariable and multivariable regression analyses identified its predictors. A total of 154 patients were included in the analysis. The 45 patients (29%) that achieved the Tetrafecta were younger (59 vs. 62 years; p = 0. 01) and presented with fewer comorbidities (ASA score ≥ 3: 0% vs. 24%; p < 0. 001). Although indicated, ILND was omitted in 8 cases (5%), while in 16, a modified template was properly used. Although median LNs yield was 17 (IQR: 11-27), 35% of the patients had <7 nodes retrieved from the groin. At Kaplan-Maier analysis, the Tetrafecta cohort displayed significantly higher OS probabilities (Log Rank = 0. 01). Uni- and multivariable logistic regression analyses identified age as the only independent predictor of Tetrafecta achievement (OR: 0. 97; 95%CI: 0. 94-0. 99; p = 0. 04). Our Tetrafecta is the first combined outcome to comprehensively report results after PC surgery. It is widely applicable, based on standardized and reproducible variables and it predicts all-cause mortality.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Tetrafecta ; Inguinal lymphadenectomy ; Penile cancer ; Surgical quality ; Survival
Published in:	Current Oncology, Vol. 30 Núm. 2 (february 2023) , p. 1882-1892, ISSN 1718-7729

DOI: 10.3390/curroncol30020146
PMID: 36826107

11 p, 753.9 KB

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Articles > Research articles
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