Early experience in intermediate-risk penile cancer with sentinel node identification using the gamma probe

Area of Science:

• Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Penile cancer staging often involves assessing inguinal lymph node involvement.
• Sentinel lymph node biopsy (SLNB) is a minimally invasive technique to detect nodal metastasis.
• Gamma probe-guided SLNB offers precise localization of sentinel nodes.

Purpose of the Study:

• To evaluate the initial experience and accuracy of gamma probe-guided sentinel node identification in intermediate-risk penile cancer patients.
• To assess the utility of SLNB in predicting inguinal lymph node metastasis.
• To determine if SLNB can help avoid extensive groin dissection.

Main Methods:

• Technetium-99m-labeled sulfur colloid was injected at the primary tumor site.
• Sentinel lymph nodes were identified and excised using a gamma probe.
• Full groin dissection was performed only if frozen section analysis of the sentinel node revealed metastasis.

Main Results:

• Nine sentinel nodes were identified and excised in 5 patients.
• Three patients had negative sentinel nodes; two had a single focus of metastasis.
• Full groin dissection in metastatic cases revealed no additional nodal involvement. All patients remained recurrence-free.

Conclusions:

• Gamma probe-guided sentinel node biopsy is highly accurate in detecting inguinal lymph node metastasis in intermediate-risk penile cancer.
• Negative sentinel nodes predict absence of recurrence, sparing patients full groin dissection.
• This technique shows promise in reducing morbidity associated with extensive lymphadenectomy.