Faculty Opinions recommendation of Development and evaluation of a nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes.

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.

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Predictors of inguinal lymph node metastasis in penile cancer patients: a meta-analysis of retrospective studies

Cancer Management and Research ◽

10.2147/cmar.s206579 ◽

2019 ◽

Vol Volume 11 ◽

pp. 6425-6441 ◽

Cited By ~ 3

Author(s):

Jiao Hu ◽

Yu Cui ◽

Peihua Liu ◽

Xu Zhou ◽

Wenbiao Ren ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Penile Cancer ◽

Retrospective Studies ◽

Inguinal Lymph Node ◽

Meta Analysis ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis

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Predictive Factors of Inguinal Lymph Node Metastasis in Men with Penile Cancer at Sanglah Hospital, Denpasar, Bali

JBN (Jurnal Bedah Nasional) ◽

10.24843/jbn.2017.v01.i02.p02 ◽

2017 ◽

Vol 1 (2) ◽

pp. 39

Author(s):

AK Harmaya ◽

IW Yudiana ◽

AAG Oka ◽

W Djatisoesanto

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Predictive Factors ◽

Primary Tumor ◽

Vascular Invasion ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis ◽

Pathologic Stage

Objective: to know the predictive factors of inguinal lymph node metastasis in men with penile cancer. Methods: this was a retrospective study on 65 patients with penile cancer in Sanglah Hospital, Denpasar, Bali from 2011 to 2015. Patients were included in analysis if they had undergone partial or total penectomy, and inguinal lymph-node dissection or excisional biopsy. Inguinal lymph node metastasis was defined as tumor positive node based on histopathology finding in patients who underwent inguinal lymph node dissection or excisional biopsy. Data retrieved from this study was analyzed by Chi Square and Kruskal-Wallis test. Results: a total of 65 patients diagnosed as penile cancer in Sanglah Hospital, Denpasar, Bali from 2011 to 2015. Mean age of these patients was 53.24 ± 13.42 years. The youngest age was 27 years old and the oldest was 86 years old. Fifteen patients were excluded for different reasons, remaining 50 patients for further analysis. From 50 patients included in analysis, 25 patient (50%) had inguinal lymph node metastasis. There were significant correlation between pathologic stage of the primary tumor (p=0.021), histologic grade (p=0.020), and vascular invasion (p=0.008) with the presence of inguinal lymph node metastasis. Based on pathologic stage of the primary tumor, only 1 of 7 patients (14%) with pT1 had inguinal lymph node metastasis compared with 10 of 24 patients (42%) with pT2, 10 of 15 patients (67%) with pT3, and 4 of 4 patients with pT4 (100%). Based on histologic grade, only 2 of 9 patients (22%) with grade I had inguinal lymph node metastasis compared with 18 of 36 patients (50%) with grade II, and 5 of 5 patients (100%) with grade III. Based on vascular invasion, only 15 of 38 patients (39%) without vascular invasion had inguinal lymph node metastasis compared with 10 of 12 patients (83%) with vascular invasion. No significant correlation was found between age and the presence of inguinal lymph node metastasis (p=0.829). Conclusion: pathologic stage of the primary tumor, histologic grade, and vascular invasion were predictive factors of inguinal lymph node metastasis in men with penile cancer.

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Salvage Surgical Resection for Isolated Locally Recurrent Inguinal Lymph Node Metastasis of Penile Cancer: International Study Collaboration

The Journal of Urology ◽

10.1016/j.juro.2014.02.2563 ◽

2014 ◽

Vol 192 (3) ◽

pp. 760-764 ◽

Cited By ~ 13

Author(s):

Adam S. Baumgarten ◽

Eihab Alhammali ◽

Tariq S. Hakky ◽

Patrick N. Espiritu ◽

Julio M. Pow-Sang ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Surgical Resection ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

International Study ◽

Inguinal Lymph Node Metastasis ◽

Node Metastasis ◽

Locally Recurrent

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Discussion on the Necessity of Bilateral Inguinal Lymphatic Area Irradiation for Cervical Cancer with Invasion of the Lower One Third of Vagina

10.21203/rs.3.rs-125329/v1 ◽

2020 ◽

Author(s):

Lina Wang ◽

Kejin Huang ◽

Yuxia Wang ◽

Le Wang ◽

Qi Li ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Inguinal Lymph Node ◽

Inguinal Lymph Node Metastasis ◽

Inguinal Lymph Nodes ◽

Radiotherapy Group ◽

Node Metastasis ◽

Lymph Node Irradiation

Abstract Background The rate of inguinal lymph node metastasis is relatively low in cervical cancer patients.According to the NCCN (National Comprehensive Cancer Network) guidelines for cervical cancer,patients with cervical cancer invading the lower 1/3 of the vagina require bilateral inguinal lymphatic area preventive irradiation. But do they need preventive inguinal area irradiation? Methods A total of 184 patients with cervical cancer accompanied by the lower 1/3 of the vagina invasion were selected as the study subjects.In this study, a trial and control method was used to select 180 patients without inguinal lymph node metastasis.The patients were divided into preventive radiotherapy group (109 cases) and non-preventive radiotherapy group (71 cases). During and after treatment, the occurrence of inguinal skin damage, lower extremity edema and femoral head necrosis was observed. Results Thirteen cases (7.07%) of 184 patients were found with inguinal lymph node enlargement by imaging examination, and only 4 cases (2.17%) were further confirmed by pathology.In prophylaxis irradiation group, there were 26(23.85%) cases of side injury.In the follow-up of two groups after treatment there was no recurrence in the inguinal lymph nodes. Conclusion The inguinal lymph node metastasis rate in patients with cervical cancer invading the lower third of the vagina is 2.17%.In order to avoid such a low incidence, we carry out preventive irradiation, which will cause 23.85% of local secondary injuries .And even if we do not perform preventive inguinal lymph node irradiation, there is no difference in the recurrence rate of inguinal lymph nodes between the two groups. Preventive inguinal lymph node irradiation isn’t necessary for these patients.

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