Evaluation of dynamic lymphoscintigraphy and sentinel lymph‐node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma

Hadway, Paul; Smith, Yuko; Corbishley, Cathy; Heenan, Susan; Watkin, N.

doi:10.1111/j.1464-410x.2007.07013.x

Cited by 78 publications

(31 citation statements)

References 23 publications

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“…This resulted in a 66% test sensitivity that was comparable with the literature and reinforced the need for surgical exploration of the inguinal region without lymphoscintigraphic detection of the sentinel lymph node (4,5,20,21).…”

Section: Commentssupporting

confidence: 62%

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection

et al. 2008

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Introduction: In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile cancer and at least one negative inguinal region. Materials and Methods:In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. Results: The mean age of the study sample was 57.7 years (44 -81 years) and the sentinel lymph node presented 0% false negative 66% sensitivity, and 79.3% specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment. Conclusion: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions. However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers.

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Section: Commentssupporting

confidence: 62%

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection

et al. 2008

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“…Some authors have even proposed that because of the difficulty in learning and the complexity of the procedure, its use should be limited to centres specializing in this technique [24,25].…”

Section: Dslnb With the Aid Of 99mmentioning

confidence: 99%

“…The technique has also been used in the management of patients with penile SCC and clinically impalpable inguinal nodes [16,[20][21][22][23][24][25]. The morbidity of DSLNB ( ≈ 8%) is considerably less than that of complete ILND (50-88%) [6,23].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of dynamic sentinel lymph node biopsy in patients with squamous cell carcinoma of the penis and palpable inguinal nodes

Heyns

Theron

2008

BJU International

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taken to the operating room for DSLNB, resection of the penile tumour and simultaneous ILND, if considered indicated (G2-3 and/or T3-4 primary tumour). During surgery 2 mL of colloidal blue dye was injected in the same area as the previous 99m Tc-nanocolloid injection. The SLNs were located during surgery using a γ -probe and visualization of blue dye in the node(s), which were then surgically removed. After partial or total penectomy, selected patients had ILND through a 10-cm subinguinal incision. The primary tumour, SLNs and ILND specimens were assessed histopathologically, using haematoxylin and eosin staining only. RESULTSBiopsy of the primary tumour showed SCC grade 1 in six, grade 2 in 13 and grade 3 in two patients. The clinical T stage was T1 in two, T2 in seven, T3 in 13 and T4 in one. There were clinically palpable inguinal lymph nodes bilaterally in 19 and unilaterally in four men. Scintigraphy before surgery showed inguinal nodes bilaterally in 12 and unilaterally in eight patients, while there were no nodes in three. Surgery comprised partial penectomy in 14, radical penectomy in eight and circumcision alone in one patient. Simultaneous bilateral ILND was done in 15 patients. Inguinal node metastases were present in four of the 23 (17%) patients; the SLN was falsely negative in three (13%), one of whom had a small focus of cancer in the SLN that was missed on initial histopathological examination, and in two the dynamically located SLN contained no cancer, but node metastases were found in the ILND specimen. CONCLUSIONThe relatively high false-negative rate of DSLNB indicates that it is not sufficiently reliable to replace complete ILND in men with a high suspicion of nodal metastases, i.e. a high-grade or high-stage primary lesion with clinically palpable inguinal nodes.

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“…Centralisation has resulted in greater use of penile-preserving surgery with reconstruction, attempting to preserve penile form and function as much as possible. 3 In addition, inguinal sentinel lymph-node sampling has been introduced, 4,5 after pioneering work from Amsterdam. 6 This technique significantly reduces the morbidity of inguinal node surgery whilst providing accurate staging information.…”

Section: Introductionmentioning

confidence: 99%

Trends in incidence, mortality and treatment of penile cancer before and after centralisation of penile cancer services in England (1990–2009)

Ayres

Iles

Hounsome

et al. 2017

Journal of Clinical Urology

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Objective: Penile cancer services were centralised in England in 2002. Has this had an impact on treatments for penile cancer and survival? Patients and methods: All cases of penile cancer from 1990 to 2009 were identified from national cancer registry data. Mortality data were obtained from the Office for National Statistics and survival data were extracted from a national population-based database, the Cancer Information System. Socioeconomic deprivation was calculated using a national income deprivation score and surgical treatments were obtained from Hospital Episode Statistics (HES) data. Results: The number of penile cancer cases recorded rose from 300 to 400 per year during the early period of centralisation. There was a significant rise in the age-standardised incidence of penile cancer from 1.2 per 100,000 to 1.4 per 100,000 during this period. Mortality remained stable at 0.3 per 100,000. One-year and five-year relative survival remained stable after centralisation at 88% and 72% respectively. The incidence and mortality of penile cancer was significantly higher in the most deprived quintile of the population. Following centralisation, the number of total penile amputations was low at 11% but only 39% of men were recorded as having lymph node surgery, although this may reflect poor compliance with coding rather than true practice. Conclusions: The incidence of penile cancer in England is rising, but mortality and survival remains stable. Incidence and mortality is higher in more deprived areas, and greater public awareness of this disease and its risk factors are needed. By 2009, rates of penile amputation were low but potentially the proportion of lymph-node surgery remained low. This may change with the uptake of inguinal sentinel lymph-node sampling.

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Evaluation of dynamic lymphoscintigraphy and sentinel lymph‐node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma

Cited by 78 publications

References 23 publications

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection

Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection

Evaluation of dynamic sentinel lymph node biopsy in patients with squamous cell carcinoma of the penis and palpable inguinal nodes

Trends in incidence, mortality and treatment of penile cancer before and after centralisation of penile cancer services in England (1990–2009)

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