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Inguinal Lymph Nodes in Carcinoma Penis-Observation or Surgery?
Syed Althaf1, Rajkumar P Narayanakar2, Dinesh M Gangaiah3
1Associate Professor, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology , Bangalore, India .
Introduction:
In Indian sub-continent the presentation of carcinoma penis is variable. Mostly presents with palpable inguinal lymph nodes but not confirm of metastases.
Aim:
To evaluate whether all clinically positive nodes are metastatic and decide when to address inguinal lymph node.
Materials And Methods:
A retrospective observational study on carcinoma penis from a regional cancer centre of south India over a period from 2001 to 2012. All the clinical, investigational, operative, pathology details and follow-up data were collected from patient records.
Results:
Two hundred and thirty cases of carcinoma penis have been identified and 112 cases had clinically positive nodes. In 74 cases fine needle cytology was positive for malignancy and they have been addressed with block dissection with surgery of primary lesion. At two years follow up, 70 patients were identified with inguinal lymph node metastasis and block dissection was performed and all was were positive for malignancy on histology. The rate of recurrence is related to the T stage of the primary tumour.
Conclusion:
It can be concluded that elective surgery is appropriate for palpable inguinal lymph nodes and prophylactic nodal dissection in high risk cases of carcinoma penis.