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Lymph node surgery after centralization of penile cancer care in Sweden : Extent of use and complications

Warnolf, Åsa LU orcid ; Baseckas, Gediminas ; Glombik, Dominik ; Hagberg, Oskar LU ; Kirrander, Peter ; Kohestani, Kimia ; Nordlund, Per ; Persson, Erik ; Liedberg, Fredrik LU and Gerdtsson, Axel LU (2026) In BJUI Compass 7(5).
Abstract

Objectives: The objective of this study is to compare the use of lymph node surgery and complication rates before and after centralization of penile cancer (PeCa) surgery in Sweden. In January 2015, curative surgical care for PeCa was centralized to the Skåne University Hospital in Malmö and the Örebro University Hospital in Örebro. Patients and Methods: All 1079 patients with invasive PeCa in the Swedish National Penile Cancer Register (NPECR) diagnosed between 2009 and 2020 were included, 458 before and 621 after centralization. The proportion of patients subjected to lymph node surgery 2009–2014 versus 2015–2020 was compared using Pearson's Chi-squared test. Odds ratios (ORs) for complications were calculated using a logistic... (More)

Objectives: The objective of this study is to compare the use of lymph node surgery and complication rates before and after centralization of penile cancer (PeCa) surgery in Sweden. In January 2015, curative surgical care for PeCa was centralized to the Skåne University Hospital in Malmö and the Örebro University Hospital in Örebro. Patients and Methods: All 1079 patients with invasive PeCa in the Swedish National Penile Cancer Register (NPECR) diagnosed between 2009 and 2020 were included, 458 before and 621 after centralization. The proportion of patients subjected to lymph node surgery 2009–2014 versus 2015–2020 was compared using Pearson's Chi-squared test. Odds ratios (ORs) for complications were calculated using a logistic regression model adjusting for age, nodal stage and extent of penile surgery. Continuous variables were presented as medians and compared using Wilcoxon's rank sum test. Results: Before centralization, 270/458 (59%) of patients were subjected to lymph node surgery compared to 474/621 (76%) after 2014. Overall complication rate for patients undergoing such surgery was unaltered before and after centralization. The incidence of any complications increased after Dynamic Sentinel Lymph Node Biopsy from 18% (22/122) to 36% (91/256), corresponding to an adjusted OR of 1.89 (95% confidence interval [CI] 1.09–3.27). For lymphocele, lymphedema or infection after modified or radical inguinal or pelvic lymphadenectomy, the adjusted OR was 0.47 (95% CI 0.29–0.75) after centralization. The register-based setting is a study limitation. Conclusions: The proportion of men undergoing lymph node surgery increased, and the risk of lymphocele, lymphedema and infection after inguinal and pelvic lymph node surgery decreased after centralization of PeCa care.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
centralization, complications, lymph node surgery, penile cancer
in
BJUI Compass
volume
7
issue
5
article number
e70220
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105037589080
  • pmid:42080029
ISSN
2688-4526
DOI
10.1002/bco2.70220
language
English
LU publication?
yes
additional info
.
id
f19102e4-c0ba-4198-b430-84ee1b158c43
date added to LUP
2026-08-11 11:00:31
date last changed
2026-08-25 11:57:09
@article{f19102e4-c0ba-4198-b430-84ee1b158c43,
  abstract     = {{<p>Objectives: The objective of this study is to compare the use of lymph node surgery and complication rates before and after centralization of penile cancer (PeCa) surgery in Sweden. In January 2015, curative surgical care for PeCa was centralized to the Skåne University Hospital in Malmö and the Örebro University Hospital in Örebro. Patients and Methods: All 1079 patients with invasive PeCa in the Swedish National Penile Cancer Register (NPECR) diagnosed between 2009 and 2020 were included, 458 before and 621 after centralization. The proportion of patients subjected to lymph node surgery 2009–2014 versus 2015–2020 was compared using Pearson's Chi-squared test. Odds ratios (ORs) for complications were calculated using a logistic regression model adjusting for age, nodal stage and extent of penile surgery. Continuous variables were presented as medians and compared using Wilcoxon's rank sum test. Results: Before centralization, 270/458 (59%) of patients were subjected to lymph node surgery compared to 474/621 (76%) after 2014. Overall complication rate for patients undergoing such surgery was unaltered before and after centralization. The incidence of any complications increased after Dynamic Sentinel Lymph Node Biopsy from 18% (22/122) to 36% (91/256), corresponding to an adjusted OR of 1.89 (95% confidence interval [CI] 1.09–3.27). For lymphocele, lymphedema or infection after modified or radical inguinal or pelvic lymphadenectomy, the adjusted OR was 0.47 (95% CI 0.29–0.75) after centralization. The register-based setting is a study limitation. Conclusions: The proportion of men undergoing lymph node surgery increased, and the risk of lymphocele, lymphedema and infection after inguinal and pelvic lymph node surgery decreased after centralization of PeCa care.</p>}},
  author       = {{Warnolf, Åsa and Baseckas, Gediminas and Glombik, Dominik and Hagberg, Oskar and Kirrander, Peter and Kohestani, Kimia and Nordlund, Per and Persson, Erik and Liedberg, Fredrik and Gerdtsson, Axel}},
  issn         = {{2688-4526}},
  keywords     = {{centralization; complications; lymph node surgery; penile cancer}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{BJUI Compass}},
  title        = {{Lymph node surgery after centralization of penile cancer care in Sweden : Extent of use and complications}},
  url          = {{http://dx.doi.org/10.1002/bco2.70220}},
  doi          = {{10.1002/bco2.70220}},
  volume       = {{7}},
  year         = {{2026}},
}