Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection.

Area of Science:

• Oncology
• Surgical Oncology
• Nuclear Medicine

Background:

• Penile cancer management for clinically negative inguinal regions lacks a standardized approach, ranging from observation to radical dissection.
• Accurate staging of inguinal lymph nodes is crucial for determining appropriate treatment and prognosis in penile cancer patients.

Purpose of the Study:

• To evaluate the effectiveness and accuracy of sentinel lymph node biopsy (SLNB) using lymphoscintigraphy in patients with penile cancer and clinically negative inguinal regions.
• To compare SLNB results with modified inguinal lymphadenectomy as the gold standard for detecting regional metastasis.

Main Methods:

• A study involving 18 patients with penile cancer and 32 clinically negative inguinal regions.
• Performance of sentinel lymph node biopsy followed by modified radical lymphadenectomy in all assessed inguinal regions.
• Analysis of clinical staging, pathological findings of sentinel and other lymph nodes, tumor behavior, recurrence, and mortality.

Main Results:

• The sentinel lymph node biopsy demonstrated a 0% false-negative rate.
• Sensitivity and specificity of SLNB were 66% and 79.3%, respectively, when compared to modified inguinal lymphadenectomy.
• The mean age of the study participants was 57.7 years.

Conclusions:

• Sentinel lymph node biopsy is a viable technique for assessing regional metastasis in penile cancer patients with clinically negative inguinal regions.
• Further optimization of lymphoscintigraphy techniques is necessary, particularly in high-volume centers, to enhance its effectiveness.
• SLNB offers a less invasive staging option compared to complete lymphadenectomy for selected penile cancer patients.