Photo Credit: Mariam Arsaliaa

The following is a summary of “Predicting Limited Survival Following Inguinal Lymph Node Dissection in Penile Cancer: Should We Revisit the Goals of Care?,” published in the OCTOBER 2023 issue of Urology by Hugar, et al.

For a study, researchers sought to create a predictive model aimed at identifying patients with advanced penile squamous cell cancer who are likely to benefit from early palliative care consultation.

Patients undergoing inguinal lymph node dissection for penile squamous cell cancer were identified from both the National Cancer Database (NCDB) and a multi-institutional international dataset (INT). A multivariable Cox proportional hazards model for overall survival (OS) was developed using the NCDB and then applied to the INT dataset. Receiver operating characteristic (ROC) curves were generated using model parameters. Optimized ROC-related criteria were employed to establish a predictive probability cut point, enabling the categorization of patients from the INT dataset into risk groups for limited OS, specifically less than 6 and 12 months.

In the NCDB, 860 deaths were observed, with 105 (5%) occurring at 6 months and 296 (15%) at 12 months. The INT dataset recorded 257 deaths, including 56 (8%) at 6 months and 124 (18%) at 12 months. Limited OS was associated with factors such as older age, increased T and N stage, and a lower number of removed lymph nodes. The optimized ROC criteria, particularly using the OS <6 months curve, effectively dichotomized patients in the INT dataset into a high-risk group with a median OS of 24 months (95% CI 18-34) and a low-risk group with a median OS of 174 months (95% CI 120-NE).

The study successfully developed a straightforward predictive model, which serves as a potential screening tool for early palliative care referral in patients with advanced penile squamous cell cancer. The model’s simplicity enhanced its practicality for clinical application, offering a valuable approach to identifying individuals who may benefit from timely palliative care intervention.

Source: goldjournal.net/article/S0090-4295(23)00590-3/fulltext