Abstract：
Management of men with penile squamous cell carcinoma (PSCC) who have high-risk features following radical inguinal lymphadenectomy (ILND) remains controversial. European Association of Urology guidelines state that adjuvant inguinal radiotherapy (AIRT) is \"not generally recommended\". Despite this, many centres continue to offer AIRT to a subset of men.
To undertake a systematic review of the evidence on AIRT in node-positive men with PSCC.
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with no language or date restriction. Inclusion criteria were men with PSCC, pathologically staged inguinal node positive after ILND. The intervention included ILND with AIRT compared with ILND alone. Primary outcomes were relapse-free survival and toxicity. Risk of bias assessment was undertaken.
A total of 913 abstracts were identified and screened independently by two reviewers. Seven studies were eligible for inclusion: six full-text manuscripts and one conference abstract. All were retrospective series and at a high risk of bias. The selected studies included 1605 men. Indications for AIRT varied but were typically involvement of two or more inguinal nodes or extranodal extension. Regional recurrence rate following AIRT was reported at 10-91.7%. Only one study reported on toxicity. Two studies compared recurrence and survival between men who received and who did not receive AIRT, with no significant difference (p>0.05).
The evidence indicates that men treated with AIRT do not gain benefit with respect to relapse or survival. Uncertainty remains due to the retrospective nature and high risks of bias across the evidence. Given the lack of evidence supporting AIRT, it cannot be recommended for routine practice.
Men with penile cancer who have involvement of the inguinal lymph nodes are at a high risk of cancer recurrence and death. We reviewed the literature to see if radiation treatment after removal of the nodes provided benefit. We did not find any good-quality evidence supporting this treatment, and hence it cannot be recommended.
To undertake a systematic review of the evidence on AIRT in node-positive men with PSCC.
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with no language or date restriction. Inclusion criteria were men with PSCC, pathologically staged inguinal node positive after ILND. The intervention included ILND with AIRT compared with ILND alone. Primary outcomes were relapse-free survival and toxicity. Risk of bias assessment was undertaken.
A total of 913 abstracts were identified and screened independently by two reviewers. Seven studies were eligible for inclusion: six full-text manuscripts and one conference abstract. All were retrospective series and at a high risk of bias. The selected studies included 1605 men. Indications for AIRT varied but were typically involvement of two or more inguinal nodes or extranodal extension. Regional recurrence rate following AIRT was reported at 10-91.7%. Only one study reported on toxicity. Two studies compared recurrence and survival between men who received and who did not receive AIRT, with no significant difference (p>0.05).
The evidence indicates that men treated with AIRT do not gain benefit with respect to relapse or survival. Uncertainty remains due to the retrospective nature and high risks of bias across the evidence. Given the lack of evidence supporting AIRT, it cannot be recommended for routine practice.
Men with penile cancer who have involvement of the inguinal lymph nodes are at a high risk of cancer recurrence and death. We reviewed the literature to see if radiation treatment after removal of the nodes provided benefit. We did not find any good-quality evidence supporting this treatment, and hence it cannot be recommended.
摘要：
腹股沟淋巴结清扫术（ILND）后具有高风险特征的阴茎鳞状细胞癌（PSCC）男性的治疗仍存在争议。欧洲泌尿外科协会指南指出，辅助腹股沟放疗（AIRT）是“一般不推荐的”。尽管如此,许多中心继续向一部分男性提供AIRT.
对PSCC节点阳性男性的AIRT证据进行系统评价。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价。没有语言或日期限制。纳入标准为男性PSCC，ILND后病理分期腹股沟淋巴结阳性。与单独的ILND相比，干预措施包括使用AIRT的ILND。主要结果是无复发生存率和毒性。进行偏倚风险评估。
共有913篇摘要由两名审稿人独立鉴定和筛选。七项研究有资格纳入：六份全文手稿和一份会议摘要。所有患者均为回顾性系列，存在较高的偏倚风险。选定的研究包括1605名男性。AIRT的适应症各不相同，但通常涉及两个或多个腹股沟淋巴结或结外延伸。据报道，AIRT后的区域复发率为10-91.7％。只有一项研究报告了毒性。两项研究比较了接受和未接受AIRT的男性之间的复发和生存率，无显著性差异(p>0.05)。
证据表明，接受AIRT治疗的男性在复发或生存方面没有获益。由于证据的回顾性性质和偏见的高风险，不确定性仍然存在。鉴于缺乏支持AIRT的证据，它不能被推荐用于常规练习。
患有阴茎癌的男性腹股沟淋巴结受累，癌症复发和死亡的风险很高。我们回顾了文献，以了解去除结节后的放射治疗是否有益。我们没有找到任何支持这种治疗的高质量证据，因此，它不能被推荐。
对PSCC节点阳性男性的AIRT证据进行系统评价。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价。没有语言或日期限制。纳入标准为男性PSCC，ILND后病理分期腹股沟淋巴结阳性。与单独的ILND相比，干预措施包括使用AIRT的ILND。主要结果是无复发生存率和毒性。进行偏倚风险评估。
共有913篇摘要由两名审稿人独立鉴定和筛选。七项研究有资格纳入：六份全文手稿和一份会议摘要。所有患者均为回顾性系列，存在较高的偏倚风险。选定的研究包括1605名男性。AIRT的适应症各不相同，但通常涉及两个或多个腹股沟淋巴结或结外延伸。据报道，AIRT后的区域复发率为10-91.7％。只有一项研究报告了毒性。两项研究比较了接受和未接受AIRT的男性之间的复发和生存率，无显著性差异(p>0.05)。
证据表明，接受AIRT治疗的男性在复发或生存方面没有获益。由于证据的回顾性性质和偏见的高风险，不确定性仍然存在。鉴于缺乏支持AIRT的证据，它不能被推荐用于常规练习。
患有阴茎癌的男性腹股沟淋巴结受累，癌症复发和死亡的风险很高。我们回顾了文献，以了解去除结节后的放射治疗是否有益。我们没有找到任何支持这种治疗的高质量证据，因此，它不能被推荐。
