ArticleAmerican journal of cancer research2026
Clinical outcomes of inguinal lymph node dissection via the lower abdominal wall approach in patients with penile cancer and risk factors for postoperative lymphatic leakage.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the efficacy of the trans-abdominal wall approach for inguinal lymph node dissection (ILND) in patients with penile cancer and to identify independent risk factors for postoperative lymphatic leakage and flap necrosis.
methodsA retrospective cohort study was conducted on 120 patients with penile cancer who underwent trans-abdominal wall approach ILND between January 2018 and December 2019. Based on 3-year follow-up outcomes, patients were divided into a no-complication group (without lymphatic leakage or flap necrosis, n = 84) and a complication group (with lymphatic leakage and/or flap necrosis, n = 36). Demographic, clinical, pathological, and follow-up data were collected. Progression-free survival (PFS) was estimated using the Kaplan-Meier method. Univariate and multivariable logistic regression analyses were performed to identify independent risk factors for postoperative complications.
resultsThe median follow-up was 36 months. The 3-year PFS rate was 7.5%, and the overall survival rate was 40.0%. In the entire cohort, 40 cases (33.3%) of lymphatic leakage and 4 cases (3.3%) of flap necrosis were observed. Multivariable logistic regression for lymphatic leakage identified older age (OR = 1.115, 95% CI: 1.020-1.219, P = 0.017), prolonged surgery time (OR = 1.072, 95% CI: 1.027-1.118, P = 0.001), positive lymph node count ≥ 2 (OR = 7.200, 95% CI: 1.641-31.588, P = 0.009), and T3 stage (OR = 9.212, 95% CI: 1.234-68.788, P = 0.030) as independent risk factors, while higher preoperative albumin levels were protective (OR = 0.598, 95% CI: 0.479-0.747, P < 0.001). Patients in the complication group had significantly lower EORTC QLQ-C30 scores compared with those in the no-complication group (57.55 ± 11.03 vs. 82.70 ± 6.69, P < 0.001).
conclusionsTrans-abdominal wall approach ILND provides satisfactory oncological outcomes with acceptable complication rates in patients with penile cancer and inguinal lymph node metastasis. Advanced age, prolonged surgery time, positive lymph node count ≥ 2, and T3 stage are independent risk factors for lymphatic leakage, whereas higher preoperative albumin levels are protective. Postoperative complications significantly impair patients' quality of life, underscoring the importance of preoperative risk stratification and perioperative optimization.
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