scholarly journals Pelvic Lymph Node Dissection in Penile Cancer With Inguinal Lymph Node Extranodal Extension: A Multicenter Experience

2021 ◽  
Vol 8 ◽  
Author(s):  
Zai-Shang Li ◽  
Hui Han ◽  
Chuang-Zhong Deng ◽  
Yong-Hong Li ◽  
Chong Wu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Lymph Node Dissection ◽  
Penile Cancer ◽  
Inguinal Lymph Node ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Iliac Region ◽  
Node Metastasis

Background: The aim of this study is to determine the necessary extent of penile lymph node dissection (PLND) in penile cancer patients with inguinal lymph node extracapsular extension (ILN-ENE).Methods: Penile cancer patients who underwent PLND in 15 centers from January 2006 to April 2020 were retrospectively analyzed. PLND was performed in patients with ILN-ENE.Results: Sixty-two patients with ILN-ENE were included in the analysis. A total of 51.6% (32/62) of the patients were confirmed to have pelvic lymph node metastasis (PLNM), and 31.3% (10/32) of patients were confirmed to have multiple PLNMs. Of the patients with metastases, 59.4% (19/32) had bilateral inguinal lymph node metastasis (ILNM). According to the anatomical structure, 71.9% (23/32) of the patients had PLNM in the external iliac region, and 56.2% (18/32) had PLNM in the obturator region. Among those with oligo-PLNM, 65.1% (28/43) of the patients had PLNM in the external iliac region and 38.9% (15/43) had PLNM in the obturator region. A significant overall survival difference was observed between patients with the bilateral ILNM and unilateral ILNM (36-month: 21.2 vs. 53.7%, respectively, P = 0.023). Patients with bilateral ILNM had relatively poor metastasis-free survival compared with unilateral ILNM (36-month: 33.0 vs. 13.9%, respectively, P = 0.051).Conclusions: The external iliac and obturator region were the most commonly affected regions in patients with ILN-ENE, and these regions were the only affected regions in patients with oligo-PLNM. Patients with bilateral ILNM had a high risk of PLNM and worse survival.

scholarly journals Is There an Oncological Benefit of Performing Bilateral Pelvic Lymph Node Dissection in Patients with Penile Cancer and Inguinal Lymph Node Metastasis?

2021 ◽  
Vol 10 (4) ◽  
pp. 754
Author(s):  
Rodrigo Suarez-Ibarrola ◽  
Mario Basulto-Martinez ◽  
August Sigle ◽  
Mohammad Abufaraj ◽  
Christian Gratzke ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Penile Cancer ◽  
Inguinal Lymph Node ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Inguinal Lymph Node Metastasis ◽  
Node Metastasis

We aim to review the literature for studies investigating the oncological outcomes of patients with penile cancer (PC) undergoing bilateral pelvic lymph node dissection (PLND) in the presence of inguinal lymph node metastasis (LNM) who are at risk of harboring pelvic metastasis. A search of English language literature was performed using the PubMed-MEDLINE database up to 3 December 2020 to identify articles addressing bilateral PLND in PC patients. Eight articles investigating bilateral PLND met our inclusion criteria. Patients with pelvic LNM have a dismal prognosis and, therefore, PLND has an important role in both the staging and treatment of PC patients. Ipsilateral PLND is recommended in the presence of ≥2 positive inguinal nodes and/or extranodal extension (ENE). Significant survival improvements were observed with a higher pelvic lymph node yield, in patients with pN2 disease, and in men treated with bilateral PLND as opposed to ipsilateral PLND. Nevertheless, the role of bilateral PLND for unilateral inguinal LNM remains unclear. Although the EAU guidelines state that pelvic nodal disease does not occur without ipsilateral inguinal LNM, metastatic spread from one inguinal side to the contralateral pelvic side has been reported in a number of studies. Further studies are needed to clarify the disseminative pattern of LNM, in order to establish PLND templates according to patients’ risk profiles and to investigate the benefit of performing bilateral PLND for unilateral inguinal disease.

Inguinal lymph node dissection for penile cancer: Predictors of lymph node metastasis.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 386-386
Author(s):  
Adam Luchey ◽  
Patrick Espiritu ◽  
Jared Gopman ◽  
Gautum Agarwal ◽  
Julio M. Pow-Sang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Penile Cancer ◽  
Inguinal Lymph Node ◽  
Preoperative Imaging ◽  
Node Dissection ◽  
Inguinal Lymph Node Dissection ◽  
Node Metastasis ◽  
Cancer Multiple

386 Background: Inguinal lymph node dissection (ILND) for lymph node metastasis (LNM) of squamous cell carcinoma of the penis (SCCP) can be a curative surgical treatment. Having the potential to identify clinical and pathological factors that predict LNM is important because of the poor prognosis this diagnosis carries. Methods: A retrospective review of 51 patients that underwent inguinal plus pelvic lymph node dissection from 1999 to 2012 was preformed. Age, race, body mass index (BMI), significant lymphadenopathy on preoperative imaging (nodes > 1 cm), palpable lymphadenopathy, and pathologic depth of invasion and diameter of the primary penile tumor along with associated lymphovascular invasion (LVI) were recorded and analyzed as potential predictors of LNM. Results: Median patient age was 65 and the median BMI was 29.3. Thirty-nine patients (76.5%) were white, 3 (5.9%) African American, and 9 (17.6%) were Hispanic. Median primary penile tumor diameter was 3.2 cm with 7, 29, and 15 patients having well, moderate, and poorly differentiated tumors. Pre-operatively, 32 patients (62.7%) had palpable lymphadenopathy on physical exam and 26 (51.0%) had significant lymphadenopathy on imaging (93% CT, 7% MRI), with 24 (47.1%) having both findings. Thirty-one patients (60.8%) who underwent ILND had pathological LNM. On univariate analysis, palpable nodes (p < 0.001), nodes on imaging (p <0.001), having both palpable nodes and nodes on imaging (p < 0.001), age (p = 0.02), and LVI (p = 0.04), were significantly associated with LMN. On multivariate analysis, having nodes on imaging (p = 0.001) and age < 65 years (p = 0.049) were significant for predicting LNM. Conclusions: In evaluation of patients with T1-T3 penile cancer, multiple factors were predictive of LNM in our series: palpable and radiographic nodes, younger than age 65 and LVI. Inguinal adenopathy defined as more than 1 cm appears to better predict occult nodal metastasis, however, this must be weighed in terms of the additional cost and clinical yield provided by widespread adoption of pelvic (CT or MRI) imaging in all patients with aggressive primary penile tumor phenotypes.

scholarly journals Lymph Node Dissections for T3T4 Stage Penile Cancer Patients Without Preoperatively Detectable Lymph Node Metastasis Bring More Survival Benefits: A Propensity Matching Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Han Li ◽  
Yucheng Ma ◽  
Zhongyu Jian ◽  
Xi Jin ◽  
Liyuan Xiang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Penile Cancer ◽  
Cox Regression ◽  
Regression Analyses ◽  
Node Dissection ◽  
Cancer Specific Survival ◽  
Node Metastasis ◽  
Propensity Matching

Background and AimsThe current guidelines for the treatment of penile cancer patients with clinically non-invasive normal inguinal lymph nodes are still broad, so the purpose of this study is to determine which patients are suitable for lymph node dissection (LND).MethodsHistologically confirmed penile cancer patients (primary site labeled as C60.9-Penis) from 2004 to 2016 in the Surveillance, Epidemiology, and Results database were included in this analysis. Univariate and multivariate Cox regression analyses were applied to determine an overall estimate of LND on overall survival and cancer-specific survival. A 1:1 propensity matching analysis (PSM) was applied to enroll balanced baseline cohort, and further Kaplan–Meier (KM) survival analysis was used to get more reliable results.ResultsOut of 4,458 histologically confirmed penile cancer patients with complete follow-up information, 1,052 patients were finally enrolled in this analysis. Age, pathological grade, T stage, and LND were identified as significant predictors for overall survival (OS) in the univariate Cox analysis. In the multivariate Cox regression, age, pathological grade, T stage, and LND were found significant. The same results were also found in the univariate and multivariate Cox regression analyses for cancer-specific survival (CSS). After the successful PSM, further KM analysis revealed that LND could bring significant OS and CSS benefits for T3T4 patients without lymph node metastasis.ConclusionLymph node dissection may bring survival benefits for penile cancer patients without preoperatively detectable lymph node metastasis, especially for T3T4 stage patients. Further randomized control trial is needed.

Early results of laparoscopic pelvic lymph node dissection in rectal cancer surgery

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Huy Tran Duc ◽  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Node Dissection ◽  
Lateral Pelvic Lymph Node ◽  
Node Metastasis ◽  
Pelvic Lymph Node Metastasis

Abstract Introduction: There are controversies over the treatment options for pelvic lymph node metastasis in low rectal cancer. The role of neoadjuvant radiotherapy in radical treatment of pelvic lymph node metastasis is still unidentified. Total mesorectal excision (TME) with Laparoscopic pelvic lymph node dissection (LPLND) provides lower pelvic recurrence in 5 years than TME only. Material and Methods: Prospective, uncontrolled clinical trial for patients with low rectal cancer (below peritoneal fold), who had suspected lateral pelvic lymph node metastasis on MRI scan and the patients did not have contraindication for laparoscopic surgery. Result: From January 2017 to February 2018 we performed 12 cases of LPLND. There was no con-version to open surgery. The average time for lymphadenectomy is 75 minutes with an average amount of blood loss of 97ml. Only 1 case had postoperative urinary retention (8%). The rate of pos-itive pelvic node was 5.8%, with an average of resected nodes of 4.9 nodes. Lymph nodes size on MRI scan in the positive pelvic node group was 20.6mm, compared to 7mm in the negative group. Conclusion: Laparoscopic lateral pelvic lymph node dissection is a feasible and safe technique and should be done by experienced colorectal surgeons. Aging, female sex and pelvic lymph node size on MRI are related to pelvic lymph node metastasis.

Pattern of invasion is the most important prognostic factor in patients with penile cancer submitted to lymph node dissection and pathological absence of lymph node metastasis

2015 ◽  
Vol 116 (4) ◽  
pp. 584-589 ◽  
Author(s):  
Giuliano Aita ◽  
Walter Henriques da Costa ◽  
Stenio de Cassio Zequi ◽  
Isabela Werneck da Cunha ◽  
Fernando Soares ◽  
...  
Keyword(s):  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Node Metastasis ◽  
Lymph Node Dissection ◽  
Penile Cancer ◽  
Node Dissection ◽  
Node Metastasis ◽  
Important Prognostic Factor ◽  
Pattern Of Invasion
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