Lymph Node Mapping in Patients with Penile Cancer Undergoing Pelvic Lymph Node Dissection

Yao, Kai; Chen, Yue; Ye, Yunlin; Wu, Zhiming; Dong, Changfeng; Han, Hui; Li, Zaishang; Liu, Zhuowei; Wang, Yanjun; Qin, Zike; Li, Yonghong; Li, Zhiyong; Zhou, Fangjian

doi:10.1097/ju.0000000000001322

Cited by 9 publications

(11 citation statements)

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“…Moreover, there are scarce data comparing the outcomes of patients treated with bilateral vs. unilateral PLND in the presence of unilateral inguinal disease. Although the EAU guidelines state that crossover metastatic spread from one groin to the contralateral pelvis has never been reported [3], a number of studies have found metastases to pelvic nodes without ipsilateral inguinal involvement [8,12,15]. Interestingly, despite the rarely found crossover, data gathered in the current review suggest that bilateral PLND is beneficial, but the ideal candidate is yet to be determined.…”

Section: Discussionmentioning

confidence: 66%

“…Among the 57 patients with pelvic LNM, the estimated median OS was higher in the bilateral than in the unilateral group (16 vs. 11 mo., p = 0.07). Moreover, the prevalence of pelvic LNM was similar in patients with ENE and without ENE (42.9% vs. 45.8%, p = 0.74), which questions the validity of ENE for predicting pelvic LNM, as has been reported by a multitude of studies [8].…”

Section: Lymph Node Mappingmentioning

confidence: 75%

“…Chipollini et al performed PLND in 198 chemonaïve patients, of which 106 (53.5%) were bilateral dissections. The median number of lymph nodes (LN) and the median number of positive LN were 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)) and 2 (1-4), respectively. The survival analysis revealed that patients with a lymph node yield of ≥9 LN had better 5-year disease-specific survival (DSS) (64.2% vs. 47.2%), overall survival (OS) (60.3% vs. 39.8%), and recurrencefree survival (RFS) (60.3% vs. 43.2%).…”

Section: Pelvic Lymph Node Yield Impacts Survivalmentioning

confidence: 99%

“…Other studies suggest that PLND has a curative role only in patients with a single microscopic focus in the pelvic specimen [7]. A further polemic is whether PLND should be performed ipsilaterally only or bilaterally in patients with unilateral inguinal LNM since crossover from inguinal to contralateral pelvic nodes has not been well studied [8]. The rarity of PC and the lack of randomized studies preclude high-level evidence recommendations in the management of pelvic lymph nodes, and its benefit in low-risk patients remains to be confirmed.…”

Section: Introductionmentioning

confidence: 99%

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Is There an Oncological Benefit of Performing Bilateral Pelvic Lymph Node Dissection in Patients with Penile Cancer and Inguinal Lymph Node Metastasis?

Suarez-Ibarrola

Basulto-Martínez

Sigle

et al. 2021

JCM

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We aim to review the literature for studies investigating the oncological outcomes of patients with penile cancer (PC) undergoing bilateral pelvic lymph node dissection (PLND) in the presence of inguinal lymph node metastasis (LNM) who are at risk of harboring pelvic metastasis. A search of English language literature was performed using the PubMed-MEDLINE database up to 3 December 2020 to identify articles addressing bilateral PLND in PC patients. Eight articles investigating bilateral PLND met our inclusion criteria. Patients with pelvic LNM have a dismal prognosis and, therefore, PLND has an important role in both the staging and treatment of PC patients. Ipsilateral PLND is recommended in the presence of ≥2 positive inguinal nodes and/or extranodal extension (ENE). Significant survival improvements were observed with a higher pelvic lymph node yield, in patients with pN2 disease, and in men treated with bilateral PLND as opposed to ipsilateral PLND. Nevertheless, the role of bilateral PLND for unilateral inguinal LNM remains unclear. Although the EAU guidelines state that pelvic nodal disease does not occur without ipsilateral inguinal LNM, metastatic spread from one inguinal side to the contralateral pelvic side has been reported in a number of studies. Further studies are needed to clarify the disseminative pattern of LNM, in order to establish PLND templates according to patients’ risk profiles and to investigate the benefit of performing bilateral PLND for unilateral inguinal disease.

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Section: Discussionmentioning

confidence: 66%

Section: Lymph Node Mappingmentioning

confidence: 75%

Section: Pelvic Lymph Node Yield Impacts Survivalmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is There an Oncological Benefit of Performing Bilateral Pelvic Lymph Node Dissection in Patients with Penile Cancer and Inguinal Lymph Node Metastasis?

Suarez-Ibarrola

Basulto-Martínez

Sigle

et al. 2021

JCM

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“…Yao et al (page 145) from China performed detailed mapping of the pelvic lymph nodes in patients with penile cancer. 10 A median of 18 nodes was removed and pelvic node metastasis was present in 57 of 128 men (44.5%). External iliac nodes were involved in half of the patients and obturator in 36%.…”

Section: Pelvic Lymph Node Mapping In Penile Cancermentioning

confidence: 99%

This Month in Adult Urology

Smith¹

2021

Journal of Urology

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Medicine and society changed in early 2020. Worldwide shutdowns because of COVID-19 affected life for everyone but had a particular impact on hospitals and patients. The Journal of UrologyÒ chronicled many of the important changes that occurred from use of telemedicine, remote learning and proper allocation of hospital resources. Further, multiple publications in The Journal and elsewhere described methods for appropriate triage of nonCOVID patients and, in particular, performance of nonurgent or emergent surgery. These comments are being prepared months before the publication date for this issue which will be the first of the new year. What further impact COVID-19 or other unanticipated problems will have is very difficult to predict. One hopes, though, that important lessons have been learned.This issue of The Journal features a critical evaluation by Cohn et al (page 241) of scoring systems commonly used for prioritization of elective urological surgery during the pandemic. 1 Some methods relied on complex formulas, others consensus expert opinion, and still others used surgeon based scoring. None was validated and all were rapidly put into place. The study shows that the different systems result in substantially different prioritization. A sober analysis of the strengths and weaknesses of each system can help planning for future needs.

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