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Penile cancer: long-term infectious and thromboembolic complications following lymph node dissection - a population-based study (Sweden)
Örebro University, School of Medical Sciences. Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0009-0007-9517-4773
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Urology.ORCID iD: 0000-0002-2850-6009
Regional Cancer Centre Central-Sweden, Uppsala, Sweden.
Regional Cancer Centre Central-Sweden, Uppsala, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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2023 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 62, no 5, p. 458-464Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To assess the long-term risks of infectious and thromboembolic events following inguinal (ILND) and pelvic (PLND) lymph node dissection in men with penile cancer.

MATERIAL AND METHODS: A total of 364 men subjected to ILND with or without PLND for penile cancer between 2000 and 2012 were identified in the Swedish National Penile Cancer Register. Each patient was matched based on age and county of residence with six penile cancer-free men. The Swedish Cancer Register and other population-based registers were used to retrieve information on treatment and hospitalisation for selected infectious and thromboembolic events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with multiple imputation.

RESULTS: The risk of infectious events remained increased for more than five years postoperatively in men with penile cancer compared with matched controls. The palpable nodal disease was the only predictor of these events, with risk increasing with the cN stage. The HR at one, three and five years and six months postoperatively was 8.60 (95% CI 5.16-14.34), 4.02 (95% CI 2.65-6.09) and 1.93 (95% CI 1.11-3.38), respectively. An increased risk of thromboembolic events persisted for three years postoperatively. The HR at one and three years postoperatively was 13.51 (95% CI 6.53-27.93) and 2.12 (95% CI 1.07-4.20). The results correspond well with the over-prescription of anticoagulants observed during this period. An association with bulky disease (cN3) was observed.

CONCLUSIONS: Lymph node dissection for penile cancer is associated with an increased risk of infectious and thromboembolic events. The findings of this population-based study show that the risks of these events remain increased more than five years for infectious and three years for thromboembolic events. Improved awareness of long-term complications following ILND is of importance both among patients and care givers to ensure early detection and treatment.

Place, publisher, year, edition, pages
Taylor & Francis, 2023. Vol. 62, no 5, p. 458-464
Keywords [en]
Penile cancer, Sweden, complication, inguinal lymph node dissection, register
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-105785DOI: 10.1080/0284186X.2023.2206524ISI: 000979203200001PubMedID: 37130005Scopus ID: 2-s2.0-85158854563OAI: oai:DiVA.org:oru-105785DiVA, id: diva2:1754236
Available from: 2023-05-03 Created: 2023-05-03 Last updated: 2023-06-28Bibliographically approved

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Glombik, DominikDavidsson, SabinaCarlsson, JessicaSundqvist, PernillaKirrander, Peter

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