The Role of Lymph Node Fine-Needle Aspiration in Penile Cancer in the Sentinel Node Era

Abstract

Penile squamous cell carcinoma (SCC) is an uncommon condition in Western countries. Inguinal lymph nodes dissection can be curative in 20%–60% of node positive patients. However, there is a high complication rates from the dissection, thus accurate diagnosis of inguinal lymph nodes metastasis is required. Current non invasive methods to detect lymph nodes metastasis are unreliable. Dynamic Sentinel Node Biopsy (DNSB), ultrasonography (US), and fine needle aspiration (FNA) cytology were proposed to in an attempt to detect sentinel lymph node (SLN). Despite the initial high rate of false negative results, recent DSNB showed improved survival compared to wait and see policy as well as reduced mortality compared to prophylactic inguinal lymphadenectomy. In addition, the US guided FNA shown 100% of specificity in detecting clinically occult lymph nodes metastasis. We proposed an algorithm for management of lymph nodes in penile cancer and suggest that FNA with US guidance should be performed in all high risk patients and that therapeutic dissection should be performed if findings are positive.

Global research trends in penile cancer: Bibliometric and visualized analysis

“…At present, the evaluation of lymph nodes requires careful physical examination first (38). If the swollen lymph node is not touched, fine needle aspiration cytology (FNAC) is a less invasive and more accurate method to determine suspicious lymph node metastasis, or with CT/MRI and other imaging techniques (39). If it is positive, lymph node dissection should be performed, including open inguinal lymphadenectomy (OIL) and video endoscopic inguinal lymphadenectomy (VEIL).…”