Lymphadenectomy in the Surgical Management of Penile Cancer

Protzel, Chris; Alcaraz, Antonio; Horenblas, Simon; Pizzocaro, Giorgio; Zlotta, Alexandre R.; Hakenberg, Oliver W.

doi:10.1016/j.eururo.2009.02.021

Cited by 216 publications

(122 citation statements)

References 86 publications

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“…Although some studies have shown that performing therapeutic lymphadenectomy provides a survival similar to a prophylactic lymphadenectomy, more recent studies do not confirm these findings [54]. Many authors showed better results with prophylactic lymphadenectomy for treatment in lesions with invasion of the body of the penis or with inguinal resectable metastases.…”

Section: Management Of the Lymph Nodes In Penile Cancermentioning

confidence: 87%

Penile Cancer: Epidemiology and Treatment

et al. 2011

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Penile cancer is an aggressive disease, with major psychological and social impact. The etiological factors are poor genital hygiene, the presence of phimosis, viral infection, ultraviolet radiation, smoking, balanitis xerotic obliterans, and chronic lichen. Identifying prognostic factors is important to select patients at risk for lymph node metastasis and avoid unneeded lymphadenectomy. The presence of lymph node metastasis is currently the strongest prognostic factor but its evaluation is imperfect using clinical and laboratorial methods. The treatment for invasive penile cancer is based on the treatment of primary tumor, usually with amputation and regional lymphadenectomy, treatments that have a high morbidity rate.

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Section: Management Of the Lymph Nodes In Penile Cancermentioning

confidence: 87%

Penile Cancer: Epidemiology and Treatment

et al. 2011

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“…It provides prognostic information and for those patients with regional metastases may be curative [3,8,12,15]. This case series emphasises the prognostic importance of the finding of extranodal spread at IL.…”

Section: Discussionmentioning

confidence: 94%

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

Martin

Goddard

Terry

et al. 2012

British Journal of Medical and Surgical Urology

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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.

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“…The most common initial site of metastasis to the superficial ILNs is the superomedial area (Fig 3). 26,27 Inguinal metastatic spread can be unilateral or bilateral from the primary penile lesion. 28 Based on lymphoscintigraphic imaging, lymphatic drainage to both groins is seen in 80% of patients with penile cancer, unilateral drainage in 18%, and no drainage in 2%.…”

Section: Surgical Treatment Of T2-t4 Diseasementioning

confidence: 99%