PD34-11 CLINICOPATHOLOGIC FEATURES AND PROGNOSTIC FACTORS IN PATIENTS WITH PENILE CANCER WHO UNDERWENT INGUINAL LYMPHADENECTOMY WITH HISTOLOGICALLY NEGATIVE LYMPH NODES

Objectives. To provide a better understanding of the distribution of inguinal nodes in order to prevent the complications of unnecessary and extended dissections in penile cancer.Methods. The bilateral inguinal regions of 19 male cadavers were dissected. Nodal distribution was noted and quantified based on anatomical location. The superficial nodes were subdivided into quarters as follows: superomedial, superolateral, inferomedial, and inferolateral. Statistical analysis was performed comparing node distribution between quarters using one-way analysis of variance (ANOVA), and the unpairedT-test was used between superficial and deep nodes.Results. Superficial nodes were found in all inguinal regions studied (mean = 13.60), and their distribution was more prominent in the superomedial quarter (mean = 3.94) and less in the inferolateral quarter (mean = 2.73). There was statistical significance between quarters when comparing the upper group with the lower one (P=0.02). Nodes were widely distributed in the superficial region compared with deep lymph nodes (mean = 13.60 versus 1.71,P<0.001).Conclusions. A great number of inguinal lymph nodes are distributed near the classical anatomical landmarks for inguinal lymphadenectomy, more prominent in upper quadrants.

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Key architectural changes in tumor-negative lymph nodes from metastatic-free oral cancer patients are valuable prognostic factors

Clinical & Experimental Metastasis ◽

10.1007/s10585-013-9631-4 ◽

2014 ◽

Vol 31 (3) ◽

pp. 327-338 ◽

Cited By ~ 5

Author(s):

Marilena Vered ◽

Ginette Schiby ◽

Anna Schnaiderman-Shapiro ◽

Ilya Novikov ◽

Ibrahim O. Bello ◽

...

Keyword(s):

Prognostic Factors ◽

Oral Cancer ◽

Lymph Nodes ◽

Cancer Patients ◽

Oral Cancer Patients ◽

Negative Lymph Nodes

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External validation of nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes

International braz j urol ◽

10.1590/s1677-5538.ibju.2018.0756 ◽

2019 ◽

Vol 45 (4) ◽

pp. 671-678 ◽

Cited By ~ 1

Author(s):

Carlos Vaz de Melo Maciel ◽

Roberto Dias Machado ◽

Mariana Andozia Morini ◽

Pablo Aloisio Lima Mattos ◽

Ricardo dos Reis ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

External Validation ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis ◽

Negative Lymph Nodes

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Development and Evaluation of a Nomogram to Predict Inguinal Lymph Node Metastasis in Patients With Penile Cancer and Clinically Negative Lymph Nodes

The Journal of Urology ◽

10.1016/j.juro.2010.03.145 ◽

2010 ◽

Vol 184 (2) ◽

pp. 539-545 ◽

Cited By ~ 29

Author(s):

Yao Zhu ◽

Hai-Liang Zhang ◽

Xu-Dong Yao ◽

Shi-Lin Zhang ◽

Bo Dai ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis ◽

Negative Lymph Nodes

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Prognostic Factors in Penile Cancer: Should We Avoid Inguinal Lymph Node Staging?

Urologia Internationalis ◽

10.1159/000512377 ◽

2021 ◽

pp. 1-5

Author(s):

Luís Vale ◽

Bernardo Fernandes ◽

Vasco Rodrigues ◽

Paulo Dinis ◽

Carlos Silva ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Lymph Node ◽

Confidence Interval ◽

Poor Prognosis ◽

Penile Cancer ◽

Perineural Invasion ◽

Hazard Ratio ◽

Risk Of Death ◽

Inguinal Lymphadenectomy

Introduction: Penile cancer (PC) is a rare neoplasm, mostly in developed countries. Herewith, we evaluate the main prognostic factors of patients with PC undergoing surgery. Methods: This is a retrospective analysis of prognostic factors of overall survival in 65 patients with PC treated at a tertiary referral center over the last 15 years (2004–2018). Results: Almost half (48%) of the patients were diagnosed at an advanced local stage pT3/4. Thirty-eight (58%) patients underwent inguinal lymphadenectomy, and 25 (66%) were negative for lymph node (LN) invasion. Overall survival was 80% at a median follow-up of 31 months. In the multivariate analysis, the main factors of poor prognosis were nodal staging (pN) (p = 0.008) and perineural invasion (p = 0.023). The presence of LN metastasis and perineural invasion in the primary tumor increased the risk of death by 29 (hazard ratio 29.0, 95% confidence interval 2.4–354.2) and 13 (hazard ratio 12.7, 95% confidence interval 1.4–112.0) times, respectively. Discussion/Conclusion: Late diagnosis of PC has a negative impact on overall survival, as nodal invasion correlates with survival. Despite the high number of negative inguinal lymphadenectomy, we continue to advocate aggressive surgical treatment of this disease due to the poor prognosis associated with LN metastasis.

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Low pressure video endoscopic inguinal lymphadenectomy in the treatment of penile cancer: a historical control study

10.21203/rs.3.rs-71543/v1 ◽

2020 ◽

Author(s):

Peng Xian ◽

Gangjun Yuan ◽

Junyong Dai ◽

Xianli Tang ◽

Fang Yuan ◽

...

Keyword(s):

Lymph Nodes ◽

Penile Cancer ◽

Ph Value ◽

Operation Time ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Inguinal Lymphadenectomy ◽

Group 2 ◽

Control Study

Abstract Background and ObjectiveTo decrease the risk of complications of inguinal lymphadenectomy by investigating the value of low CO2 pressure video endoscopic inguinal lymphadenectomy in the treatment of penile cancer.MethodsThe clinical data of a total of 44 patients who underwent video endoscopic inguinal lymphadenectomy (VEIL) were collected for statistical analysis.ResultsThe average operation time was ( 106.88 ± 17.93) min in low CO2 pressure (LP) group and ( 115.79 ± 20.29) min in normal CO2 pressure (NP) group. The average number of lymph nodes was (10.83 ± 2.14) in LP group and (11.16 ± 1.77) ml in NP group. The intraoperative PaCO2 value was (45.51 ± 4.57) mmHg in LP group and (50.77 ± 6.50) ml in NP group. The PH value of blood gas analysis was (7.35 ± 0.05) in LP group and (7.31 ± 0.04) ml in NP group. The incidence of emphysema was 2/25 in LP group while it was 9/19 in NP group. 2 cases of skin metastasis and 1 lung metastasis were observed in NP group, but not in LP group.ConclusionsDecrease of CO2 pressure during operation will not increase the difficulty of the surgery. LP VEIL can reduce the risk of complications including hypercapnia and the subcutaneous or lung recurrence.

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

Journal of Clinical Medicine ◽

10.3390/jcm9082501 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2501

Author(s):

Reza Nabavizadeh ◽

Benjamin Petrinec ◽

Andrea Necchi ◽

Igor Tsaur ◽

Maarten Albersen ◽

...

Keyword(s):

Lymph Node ◽

Minimally Invasive ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Inguinal Lymphadenectomy ◽

Operative Complications

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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