Inguinal Lymphadenectomy for Squamous Cell Cancer of the Penis—Experience of a UK Supra-Regional Network

Abstract

Objective: To present a case series of patients undergoing inguinal lymphadenectomy (IL) for squamous cell cancer (SCC) of the penis within an UK Supra-Regional Network (SRN). Patients and methods: Retrospective case note analysis was undertaken of all patients who underwent IL following referral from the network units across a wide region. Information was cross-referenced from clinician, pathology and hospital episode databases. Results: A total of 79 modified ILs and 11 radical ILs were performed in 49 patients over 5 years. Metastatic involvement was found in 59.1% of patients. Of these 58.6% were found to have extranodal spread at the time of operation. The finding of extranodal spread significantly impacted upon survival. One year survival rates post IL were 100% for pN0 and pN1, compared with 67% for pN3.Kaplan-Meier curves were plotted and showed a significant difference in survival from primary surgery on log rank comparison between pN0/pN1 and pN3 nodal categories. As in most series, IL has a considerable morbidity rate. No perioperative mortality was seen. Conclusions: This case series emphasizes the negative prognostic impact of finding extranodal spread (pN3) at IL. In those with unilateral intranodal metastases (pN1), IL is curative for the majority of patients.