Comparing open and video endoscopic lymphadenectomy for penile cancer: a systematic review and meta‐analysis of prospective studies
Bibliographic record
Abstract
Objective To conduct the first meta‐analysis using only prospective studies to evaluate whether video endoscopic inguinal lymphadenectomy (VEIL) offers advantages in perioperative outcomes compared to open IL (OIL) in patients with penile cancer. Methods A systematic review with meta‐analysis was conducted across multiple databases, including Cochrane Central Register of Controlled Trials (CENTRAL), the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica dataBASE (EMBASE), Latin America and Caribbean Health Sciences Literature (LILACS), Scopus, Web of Science, and several trial registries up to June 2024. Only randomised controlled trials (RCTs) and prospective cohort studies were included. Data extraction focused on operative time, perioperative complications, drainage time, hospital stay, number of nodes retrieved and oncological outcomes. Results Four prospective studies, including three RCTs and one non‐randomised study, were included in the analysis, totalling 95 patients and 174 operated limbs. VEIL demonstrated significantly fewer wound infections ( P < 0.001; 95% confidence interval [CI] 0.01–0.18; I 2 = 0), skin necrosis ( P = 0.002; 95% CI 0.04–0.49; I 2 = 0), and lymphoedema ( P = 0.05; 95% CI 0.09–0.99; I 2 = 27%) compared to OIL. The VEIL group also had a shorter drainage period ( P = 0.001; mean difference [MD] –1.94, 95% CI −3.15 to −0.74) and hospital stay ( P < 0.01; MD –5.48, 95% CI −6.34 to −4.62). Pain intensity and operative time were lower in the VEIL group, contributing to fewer postoperative complications overall. Oncological outcomes showed no significant differences between the groups. Conclusion The meta‐analysis indicates that VEIL offers significant advantages over OIL in terms of reducing wound infections, skin necrosis, and lymphoedema, leading to shorter hospital stays and overall improved perioperative outcomes. However, the limited sample of 95 patients across four studies underscores the need for further randomised trials and a cautious interpretation of the results, which currently support the use of VEIL in managing patients with penile cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.040 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.051 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".