Presentation Authors: Emanuel Albuquerque*, Giuliano Guglielmetti, Pablo Sierra, José Pontes Jr, Alexandre Cavalcante, Rafael Coelho, William Nahas, SÃO PAULO, Brazil
Introduction: Penile cancer is an aggressive and uncommon disease. Greater than 95% are caused by squamous cell carcinomas (SCC).There is growing evidence to support the association of systemic inflammation in cancer development and progression. We aimed to evaluate whether systemic inflammatory markers in peripheral blood before penectomy and before radical inguinal lymph node dissection (ILND) may be prognostic marker.
Methods: We retrospectively reviewed data from 230 patients with penile cancer followed between 2009 and 2018 in a single center, to identify 126 patients who were submitted to total or partial penectomy and 79 patients who were submitted to ILND for non-metastatic PSCC. We evaluated neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) and platelet to lymphocyte ratio (PLR) obtained preoperatively. The cut-off point of NLR â‰¥ 3.0 was chosen following positive results found in previous studies in penile cancer and the cut-off point of LMR and PLR was chosen from its median. Kaplan-Meier analyses with log-rank tests were used to estimate overall survival (OS), cancer specific survival (CSS) and recurrence free survival (RFS). Cox regression analyses were used to determine predictors of survivals.
Results: Median follow up was 28 months for patients submitted to penectomy and 35 months for patients submitted to ILND. We did not find any association of NLR, PLR and LMR on multivariable analyses before penectomy with survivals. On multivariable cox regression, adjusted for age, staging T, histological grade, lymphovascular invasion and perineural invasion, before ILND, NLR â‰¥ 3.0 was associated with worse RFS, OS and CSS. LMR â‰¥ 2.99 was associated with better RFS, OS and CSS (Table 1). These results were corroborated by the Kaplan-Meier analyses with log-rank tests. The PLR had conflicting results on Cox and log-rank analyses, therefore was not considered a predictor.
Conclusions: The current study identify NLR and LMR before ILND as independent predictors of RFS, OS and CSS. More studies are needed to confirm these findings.