Comparing Outcomes of Robotic and Open Inguinal Lymph Node Dissection in Patients with Carcinoma of the Penis

Singh, Amitabh; Jaipuria, Jiten; Goel, Ashish; Shah, Swati; Bhardwaj, Raghubir; Baidya, Saroj; Jain, Jalaj; Jain, Chirag; Rawal, Sudhir

doi:10.1016/j.juro.2017.12.061

Cited by 62 publications

(54 citation statements)

References 21 publications

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“…Estimated blood loss during RVEIL in different studies ranges from 10-200 mL and appears to be comparable to open ILND as reported by Singh and colleagues [21,23]. Russell and colleagues reported a median blood loss of 50 mL per groin in 27 RVEIL groin dissections [20].…”

Section: Peri-operative Outcomes and Complicationssupporting

confidence: 65%

“…Minimally invasive techniques have primarily been described in penile cancer patients with non-palpable or small palpable lymphadenopathy. However, the use of these techniques in patients with significant palpable inguinal lymphadenopathy as well as following treatment with neoadjuvant therapy is also reported [19][20][21]. Here, we discuss utilization of these approaches including their surgical techniques, peri-operative results and complications, and oncological outcomes.…”

Section: Minimally Invasive Approachesmentioning

confidence: 96%

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Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer

Nabavizadeh

Petrinec

Necchi

et al. 2020

JCM

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Our aim is to review the benefits as well as techniques, surgical outcomes, and complications of minimally invasive inguinal lymph node dissection (ILND) for penile cancer. The PubMed, Wiley Online Library, and Science Direct databases were reviewed in March 2020 for relevant studies limited to those published in English and within 2000–2020. Thirty-one articles describing minimally invasive ILND were identified for review. ILND has an important role in both staging and treatment of penile cancer. Minimally invasive technologies have been utilized to perform ILND in penile cancer patients with non-palpable inguinal lymph nodes and intermediate to high-risk primary tumors or patients with unilateral palpable non-fixed inguinal lymph nodes measuring less than 4 cm, including videoscopic endoscopic inguinal lymphadenectomy (VEIL) and robotic videoscopic endoscopic inguinal lymphadenectomy (RVEIL). Current data suggest that VEIL and RVEIL are feasible and safe with minimal intra-operative complications. Perhaps the strongest appeal for the use of minimally-invasive approaches is their faster post-operative recovery and less post-operative complications. As a result, patients can tolerate this procedure better and surgeons can offer surgery to patients who otherwise would not be a candidate or personally willing to undergo surgery. When compared to open technique, VEIL and RVEIL have similar dissected nodal count, a surrogate metric for oncological adequacy, and a none-inferior inguinal recurrence rate. Larger randomized studies are encouraged to investigate long-term outcome and survival rates using these minimally-invasive techniques for ILND.

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Section: Peri-operative Outcomes and Complicationssupporting

confidence: 65%

Section: Minimally Invasive Approachesmentioning

confidence: 96%

Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer

Nabavizadeh

Petrinec

Necchi

et al. 2020

JCM

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“…Overall, major complications are reported in 5–21% of dissections and minor complications in 40–54% of dissections . Even the modified lymph node dissections, and those performed laparoscopically or robotically, are not without severe complications .…”

Section: Discussionmentioning

confidence: 99%

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

et al. 2019

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ObjectiveTo evaluate the predictive nature of several clinicopathological variables by developing a nomogram predictive for lymph node-positive disease using the National Cancer Database cohort of patients with squamous cell carcinoma of the penis. MethodsStepwise logistic regression was used to find the best-fit model; remaining clinical variables were used to create a nomogram to predict the probability of lymph node-positive disease. ResultsOn multivariate analysis, high pathological grade (3-4 vs 1: odds ratio [OR] 3.27, 95% confidence interval [CI] 1.70-6.29; 2 vs 1: OR 2.58, 95% CI 1.39-4.79 [P = 0.002]), lymphovascular invasion (OR 2.49, 95% CI 1.61-3.84 [P < 0.001]), and positive clinical lymph node status (N1 vs N0: OR 20.0, 95% CI 11.4-35.7; N2 vs N0: OR 27.8, 95% CI 14.1-55.6; N3 vs N0: OR 49.2, 95% CI 14.8-162.8 [P < 0.001]) were predictors of lymph node metastasis in penile cancer. The bootstrap-corrected concordance index of this nomogram was 0.880. ConclusionUsing tumour grade, tumour lymphovascular invasion and clinical lymph node status, we developed a nomogram highly predictive of pathologial lymph node metastasis that, after further external validation, could be helpful in the surgical decision-making process.

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“…Often, scrotal lymphedema leading to buried penis is the result of postoperative sequelae from surgeries such as pelvic lymph node dissection during prostatectomy, inguinal lymphadenectomy for penile cancer or melanoma, or aortobifemoral bypass grafting. In a series of 340 inguinal lymphadenectomies for penile cancer, early lymphedema rates of 4.1% and scrotal edema rates of 0.9% were noted ( 9 ) with late lymphedema rates ranging from 5–9% ( 10 , 11 ). In patients from developing countries, scrotal lymphedema is often seen as the genital manifestation of lymphatic filariasis, also known as elephantiasis.…”

Section: Managementmentioning

confidence: 99%

Evaluation and management of adult acquired buried penis

Gelman

2018

Transl. Androl. Urol.

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Adult acquired buried penis represents the clinical manifestation of a wide spectrum of pathology due to a variety of etiologies. It can be related to obesity, a laxity in connective tissue, lichen sclerosis (LS), complications from penile/scrotal enlargement surgery, scrotal lymphedema, or hidradenitis suppurativa (HS). Buried penis can be associated with poor cosmesis and hygiene, voiding dysfunction, and sexual dysfunction. Evaluation and management of buried penis largely depends on etiology and degree of affected tissue. It is an increasingly common problem seen by reconstructive urologists and here we present several frequently seen scenarios of buried penis and management options.

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Comparing Outcomes of Robotic and Open Inguinal Lymph Node Dissection in Patients with Carcinoma of the Penis

Abstract: Robot-assisted video endoscopic inguinal lymphadenectomy is a feasible technique which allows for a similar nodal yield while being associated with lower morbidity than open inguinal lymph node dissection in patients without bulky groin adenopathy.

Cited by 62 publications

References 21 publications

Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer

Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

Evaluation and management of adult acquired buried penis

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