J Cancer 2021; 12(7):1960-1966. doi:10.7150/jca.56504 This issue
1. Department of Urology, Shenzhen People's Hospital, The Second Clinic Medical College of Jinan University 518060, Shenzhen, Guangdong, P. R. China.
2. Department of Urology, First Affiliated Hospital of Southern University of Science and Technology, 518060, Shenzhen, Guangdong, P. R. China.
3. Department of Urology, Minimally Invasive Urology of Shenzhen research and Development Center of Medical Engineering and Technology, 518060, Shenzhen, Guangdong, P. R. China.
4. Department of Oncology, The Seventh Affiliated Hospital Sun Yat-sen University, 518107, Shenzhen, Guangdong, P. R. China.
5. Division of Urology, Department of Surgery, Queen Mary's Hospital, The University of Hong Kong, 999077, Hong Kong SAR, P. R. China.
6. Department of Oncology, Hospital Kiang Wu, 999078, Macao SAR, P. R. China.
7. Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, 000800, Kaohsiung, Taiwan.
8. Department of Urology, Kaohsiung Medical University Hospital, 000800, Kaohsiung, Taiwan.
9. Kaohsiung Medical University, Kaohsiung, T 000800, Taiwan.
10. Department of Urology, Brazilian National Institute of Cancer, 20230‑130, Rio de Janeiro, Brazil.
11. Department of Urology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, Guangdong, P. R. China.
12. State Key Laboratory of Oncology in South China, 510060, Guangzhou, Guangdong, P. R. China.
13. Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, Guangdong, P. R. China.
*These authors contributed equally to this research.
Objective: Changes were made in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system according to cavernosum invasion for penile squamous cell carcinoma. This study aimed to determine the difference of prognostic validity between corpora cavernosa (CC) invasion and corpus spongiosum (CS) invasion.
Methods: In this study, we searched PubMed, Cochrane CENTRAL, and Embase to select English-language articles until July 15, 2020. Pooled analyses of hazard ratios (HRs) and odds ratios (ORs) were performed.
Results: Eleven studies including 3692 cases were included in the final ananlysis (1431 cases with CC and 1360 cases with CS). According to the anatomical structure, the pooled results demonstrated that patients with CC invasion had a similar rate of LNM to those with CS invasion (OR 1.34, 95% confidence interval (CI) 0.97-1.86; P=0.076). However, patients with CC invasion had a higher rate of lymph node metastasis (LNM) than those with CS invasion according to the 8th edition tumor stage (OR 1.58, 95% CI 1.14-2.21; P<0.001). Regarding survival, patients with CS invasion obtained a significantly better cancer-specific survival (CSS) (HR, 0.67; 95% CI, 0.46-0.96; P=0.030), but not in overall survival (OS) (HR: 1.30; 95% CI, 0.52-3.20; P=0.585) than those with CC invasion. No a significant publication bias was observed by Begg's and Egger's tests.
Conclusions: The systematic comparison suggests that patients with CS invasion had better CSS than those with CC invasion. CC invasion was associated with a high risk of LNM. The conclusions should be validated by large-scale studies.
Keywords: penile cancer, prognosis, meta-analysis, lymph node metastasis, stage