TY - JOUR
T1 - Early Wound Complications After Inguinal Lymphadenectomy in Penile Cancer: A Historical Cohort Study and Risk-factor Analysis
AU - Stuiver, Martijn M.
AU - Djajadiningrat, Rosa S.
AU - Graafland, Niels M.
AU - Vincent, Andrew D.
AU - Lucas, Cees
AU - Horenblas, Simon
PY - 2013
Y1 - 2013
N2 - Background: Complication rates after inguinal lymph node dissection (ILND) are high. Risk factors for early wound complications after ILND in patients with penile carcinoma have not yet been studied. Objectives: To assess the frequency of early wound complications in a contemporary series and to identify clinical risk factors for early wound complications after ILND for penile carcinoma. Design, setting, and participants: We evaluated 237 ILNDs in 163 patients with penile cancer treated between 2003 and 2012 at the Netherlands Cancer Institute. Outcome measurements and statistical analysis: We assessed the occurrence of wound infection, skin-flap problems, and seroma formation and graded complications using the modified Clavien system. Univariable and multivariable penalised mixed effects logistic regression was used to identify clinical risk factors for occurrence of any complication (grade >= 1) and of moderate to severe complications (grade >= 2). Results and limitations: One complication or more occurred in 58% of the procedures, and 10% of those complications were severe. Wound infection occurred in 43%, seroma formation occurred in 24%, and skin-flap problems occurred in 16%. Palpable disease was the only factor associated with grade >= 1 complications in the univariable analysis (odds ratio [OR]: 0.43; p = 0.02). In the multivariable model, after penalisation, no statistically significant risk factors remained. Univariable associations for grade >= 2 complications were present for body mass index (BMI; OR of 1.66 for a 5.8-point change in BMI; p = 0.05) and sartorius muscle transposition (OR: 2.64; p = 0.04). In the reduced multivariable model, the OR for sartorius muscle transposition was 2.12 (p = 0.06) and for BMI was 1.76 (p = 0.03). In addition, bilateral dissection approached significance in the multivariable model (OR: 2.17; p = 0.06). This study is limited by its observational nature. Conclusions: Wound complication rates after ILND are high in this cohort. BMI, sartorius muscle transposition, and bilateral dissection were the factors most strongly associated with the occurrence of grade >= 2 wound complications. (C) 2013 European Association of Urology. Published by Elsevier B. V. All rights reserved
AB - Background: Complication rates after inguinal lymph node dissection (ILND) are high. Risk factors for early wound complications after ILND in patients with penile carcinoma have not yet been studied. Objectives: To assess the frequency of early wound complications in a contemporary series and to identify clinical risk factors for early wound complications after ILND for penile carcinoma. Design, setting, and participants: We evaluated 237 ILNDs in 163 patients with penile cancer treated between 2003 and 2012 at the Netherlands Cancer Institute. Outcome measurements and statistical analysis: We assessed the occurrence of wound infection, skin-flap problems, and seroma formation and graded complications using the modified Clavien system. Univariable and multivariable penalised mixed effects logistic regression was used to identify clinical risk factors for occurrence of any complication (grade >= 1) and of moderate to severe complications (grade >= 2). Results and limitations: One complication or more occurred in 58% of the procedures, and 10% of those complications were severe. Wound infection occurred in 43%, seroma formation occurred in 24%, and skin-flap problems occurred in 16%. Palpable disease was the only factor associated with grade >= 1 complications in the univariable analysis (odds ratio [OR]: 0.43; p = 0.02). In the multivariable model, after penalisation, no statistically significant risk factors remained. Univariable associations for grade >= 2 complications were present for body mass index (BMI; OR of 1.66 for a 5.8-point change in BMI; p = 0.05) and sartorius muscle transposition (OR: 2.64; p = 0.04). In the reduced multivariable model, the OR for sartorius muscle transposition was 2.12 (p = 0.06) and for BMI was 1.76 (p = 0.03). In addition, bilateral dissection approached significance in the multivariable model (OR: 2.17; p = 0.06). This study is limited by its observational nature. Conclusions: Wound complication rates after ILND are high in this cohort. BMI, sartorius muscle transposition, and bilateral dissection were the factors most strongly associated with the occurrence of grade >= 2 wound complications. (C) 2013 European Association of Urology. Published by Elsevier B. V. All rights reserved
U2 - 10.1016/j.eururo.2013.02.037
DO - 10.1016/j.eururo.2013.02.037
M3 - Article
C2 - 23490726
SN - 0302-2838
VL - 64
SP - 486
EP - 492
JO - European urology
JF - European urology
IS - 3
ER -