Management of regional lymph nodes in carcinoma of the penis

In the management of carcinoma of the penis, standard treatment of the primary tumor is by radiotherapy for small lesions (Tis, T1, T2 located in the glans) and by amputation in other cases (T2 with invasion of the shaft). The diagnosis and treatment of regional lymph nodes are thus the essential problems with this cancer. In our series of 45 patients with a minimum 5-year follow-up, clinical assessment was incorrect in 22.5% of cases (22% of the patients with negative bilateral biopsy of the superficial inguinal nodes developed metastases), and many of the complications (flap necrosis, lymphedema) occurring after inguinal lymphadenectomy contributed to a poorer quality of patient survival. A therapeutic approach to the management of regional lymph nodes in order to combat the carcinoma more effectively and improve patient survival quality is suggested.