{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T22:59:40Z","timestamp":1771023580118,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,7,6]],"date-time":"2015-07-06T00:00:00Z","timestamp":1436140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2015,11]]},"abstract":"\n Objective<\/jats:title>\n \n \n \n \n To evaluate the association between lymph node ratio (\n LNR<\/jats:styled-content>\n ) and cancer\u2010specific survival (\n CSS<\/jats:styled-content>\n ) in a population of patients with penile cancer and lymph node metastases (\n LNM<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n \n \n \n We evaluated 81 patients with pathologically determined\n LNM<\/jats:styled-content>\n who were surgically treated at our institution between 2000 and 2012.\n <\/jats:p>\n <\/jats:list-item>\n \n \n We considered\n LNR<\/jats:styled-content>\n both as a continuously coded and as a categorically coded variable. The minimum\u2010\n P<\/jats:italic>\n \u2010value approach was used to determine the most significant\n LNR<\/jats:styled-content>\n threshold.\n <\/jats:p>\n <\/jats:list-item>\n \n \n The\n K<\/jats:styled-content>\n aplan\u2013\n M<\/jats:styled-content>\n eier method was used to determine\n CSS<\/jats:styled-content>\n rates, and univariable and multivariable Cox regression models were fitted to test the predictors of\n CSS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n \n \n \n The median (interquartile range [\n IQR<\/jats:styled-content>\n ]) numbers of positive and removed lymph nodes were 2 (1\u20134) and 22 (13\u201330), respectively. The median (\n IQR<\/jats:styled-content>\n )\n LNR<\/jats:styled-content>\n was 10.3 (6.3\u201316.6)% and the most significant\n LNR<\/jats:styled-content>\n threshold was 22%. The median (\n IQR<\/jats:styled-content>\n ) follow\u2010up was 26 (16\u201362) months.\n <\/jats:p>\n <\/jats:list-item>\n \n \n Overall, the 5\u2010year\n CSS<\/jats:styled-content>\n rate was 50.5%. After stratification according to\n LNR<\/jats:styled-content>\n , 5\u2010year\n CSS<\/jats:styled-content>\n rates were 65.2% vs 9.6% in patients with\n LNR<\/jats:styled-content>\n < 22% vs\n LNR<\/jats:styled-content>\n \u2265 22%, respectively (\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:list-item>\n \n \n In multivariable\n C<\/jats:styled-content>\n ox regression models, after adjusting for several established prognostic factors,\n LNR<\/jats:styled-content>\n was as independent predictor of\n CSS<\/jats:styled-content>\n (\n P<\/jats:italic>\n \u22640.012).\n <\/jats:p>\n <\/jats:list-item>\n \n \n Finally,\n LNR<\/jats:styled-content>\n significantly improved the accuracy of multivariable Cox regression models by 4.9\u201310.5%.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n \n \n \n Although further investigations are needed to evaluate the relationship between tumour burden and treatment intensity,\n LNR<\/jats:styled-content>\n may represent a powerful predictor of\n CSS<\/jats:styled-content>\n in patients with penile cancer and pathologically determined\n LNM<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12510","type":"journal-article","created":{"date-parts":[[2013,10,15]],"date-time":"2013-10-15T12:03:31Z","timestamp":1381838611000},"page":"727-733","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Relationship between lymph node ratio and cancer\u2010specific survival in a contemporary series of patients with penile cancer and lymph node metastases"],"prefix":"10.1111","volume":"116","author":[{"given":"Giovanni","family":"Lughezzani","sequence":"first","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"},{"name":"Department of Urology San Raffaele Turro Fondazione IRCCS Ospedale San Raffaele Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Catanzaro","sequence":"additional","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tullio","family":"Torelli","sequence":"additional","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Piva","sequence":"additional","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Biasoni","sequence":"additional","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Stagni","sequence":"additional","affiliation":[{"name":"Department of Urology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Necchi","sequence":"additional","affiliation":[{"name":"Department of Oncology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Giannatempo","sequence":"additional","affiliation":[{"name":"Department of Oncology Fondazione IRCCS Istituto Nazionale Tumori Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Raggi","sequence":"additional","affiliation":[{"name":"Department of Oncology Fondazione IRCCS Istituto Nazionale Tumori Milan 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