The importance of extranodal extension in penile cancer: a meta-analysis.
Comparative Studies; Cox Proportional Hazards Model; Evaluation Research; Human; Humans; Lymph Nodes – Pathology; Lymph Nodes/pathology; Lymphatic Metastasis; Male; Meta Analysis; Multicenter Studies; Neoplasm Metastasis; Odds Ratio; Penile Neoplasms – Diagnosis; Penile Neoplasms – Mortality; Penile Neoplasms – Pathology; Penile Neoplasms/diagnosis/*mortality/*pathology; Prognosis; Proportional Hazards Models; Publication Bias; Validation Studies
BACKGROUND: The role of extranodal extension (ENE) in penile cancer is controversial and has not been well studied. The aim of this study was to investigate the importance of ENE in predicting prognosis and presence of pelvic lymph node metastasis (PLNM) in penile cancer patients. METHODS: We searched related studies in Medline, Embase, Cochrane Library, and Scopus database. Hazard ratio (HR) and odds ratio (OR) were directly extracted or indirectly estimated from the included studies. RESULTS: A total of ten studies with 1,142 patients were included in this meta-analysis. Patients with ENE showed a worse cancer-specific survival (CSS) (HR = 1.90, 95 % confidence interval [CI] = 1.35-2.67, P = 0.0002) and overall survival (HR = 4.04, 95 % CI = 1.02-16.1, P = 0.05) than those without ENE. Further subgroup analysis revealed that the predictive value of ENE for CSS in penile cancer patients was significant regardless of the study's country of origin, but not in the subgroup with shorter follow-up time (\textless36 months, P = 0.38). Patients with ENE also showed a higher incidence of presenting with PLNM (OR = 4.95, 95 % CI = 2.58-9.49, P \textless 0.001). A stratified analysis demonstrated that the predictive role of ENE for PLNM was only detected in studies with a larger sample size (\textgreater 100 cases). No significant publication bias was observed, as suggested by Begg's and Egger's tests. CONCLUSIONS: ENE is associated with worse prognosis and high risk of PLNM in penile cancer patients. Due to the limited number of studies included in this meta-analysis, a large-scale, well-designed study will be required to verify our results.
Zhang Zhi-Ling; Yu Chun-Ping; Liu Zhuo-Wei; Velet Liliya; Li Yong-Hong; Jiang Li-Juan; Zhou Fang-Jian
BMC cancer
2015
2015-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1186/s12885-015-1834-4" target="_blank" rel="noreferrer noopener">10.1186/s12885-015-1834-4</a>
The Difference in Prognosis between Renal Sinus Fat and Perinephric Fat Invasion for pT3a Renal Cell Carcinoma: A Meta-Analysis.
Female; Humans; Male; Neoplasm Staging; Odds Ratio; Prognosis; Neoplasm Invasiveness; Proportional Hazards Models; Intra-Abdominal Fat/*pathology; Kidney Neoplasms/*mortality/*pathology; Publication Bias; Carcinoma; Renal Cell/*mortality/*pathology
BACKGROUND: In the current Tumour-Node-Metastasis (TNM) classification system for renal cell carcinoma (RCC), both renal sinus fat invasion (SFI) and perinephric fat invasion (PFI) are defined as T3a, suggesting that the prognosis should be similar for the two pathologic findings. Several studies, however, have reported a worse prognosis for SFI in patients with a T3a tumor. In order to compare the prognosis of these two pathologic findings (SFI versus. PFI) in a more comprehensive way, this meta-analysis was performed. METHODS: To identify relevant studies, Medline, Embase, Cochrane Library, and Scopus database were searched from the inception until October 2014. A meta-analysis was performed using Review Manager 5.2 and STATA 11. Pooled Odds ratio (OR) and/or hazard ratio (HR) with 95% confidence interval (CI) were calculated to examine the risk or hazard association. RESULTS: A total of 6 studies including 1031 patients qualified for analysis. T3a RCC patients with SFI were significantly associated with poor cancer specific survival(CSS) (HR: 1.47, 95% CI: 1.19-1.83; P\textless0.001) compared to those with PFI. In T3aNx/N0M0 subgroup, SFI patients also showed a worse prognosis than those with PFI (CSS, HR: 1.94, 95% CI: 1.21-3.12; P = 0.006). T3a RCC patients with SFI had higher Furhman grade, greater possibility of lymph node metastasis, sarcomatoid differentiation and tumour necrosis. Main limitation is the relatively small number of included studies. CONCLUSION: The present meta-analysis suggested that SFI is associated with worse CSS in patients with pT3a RCC. However, due to the small number of included studies, future studies with a large sample size are required to further verify our findings.
Zhang Zhi-Ling; Yu Chun-Ping; Velet Liliya; Li Yong-Hong; Jiang Li-Juan; Zhou Fang-Jian
PloS one
2016
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1371/journal.pone.0149420" target="_blank" rel="noreferrer noopener">10.1371/journal.pone.0149420</a>