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Penile Cancer: Contemporary Lymph Node Management.

Jonathan S O'Brien1, Marlon Perera1, Todd Manning1

  • 1Austin Health, University of Melbourne, Heidelberg, Victoria, Australia.

The Journal of Urology
|January 25, 2017
PubMed
Summary

Minimally invasive techniques, like dynamic sentinel lymph node biopsy, improve lymph node staging in penile cancer. Further research is needed to confirm optimal management strategies for lymph node metastases.

Keywords:
amputationcarcinomaneoplasm metastasispenissentinel lymph node biopsysquamous cell

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Area of Science:

  • Urology
  • Oncology
  • Surgical Pathology

Background:

  • Optimal diagnostics and management of metastatic lymph nodes in penile cancer remain unclear.
  • Advances in minimally invasive staging, including dynamic sentinel lymph node biopsy, are expanding urological diagnostic capabilities.
  • There is a need for an objective update on managing penile squamous cell carcinoma with inguinal and pelvic lymph node metastases.

Purpose of the Study:

  • To provide an objective update on recent trends in the management of penile squamous cell carcinoma.
  • To review the diagnosis and management of inguinal and pelvic lymph node metastases in penile cancer.
  • To assess the role of minimally invasive staging techniques in penile cancer.

Main Methods:

  • Systematic review of medical databases (Web of Science, MEDLINE, Embase, Cochrane) following PRISMA guidelines.
  • Search terms included penile cancer, lymph node, sentinel node, minimally invasive, surgery, and outcomes.
  • Articles published between 1980 and 2016, including original research, reviews, and clinical guidelines, were reviewed.

Main Results:

  • Accurate, minimally invasive lymph node staging is crucial for penile cancer surgical management.
  • Sentinel lymph node biopsy is supported by growing evidence for clinically node-negative patients, offering superior sensitivity and specificity.
  • Improvements in lymphadenectomy reduce morbidity and improve outcomes; multimodal therapy benefits advanced disease.

Conclusions:

  • Minimally invasive lymph node diagnosis and intervention strategies are evolving in penile cancer management.
  • Dynamic sentinel lymph node biopsy shows excellent sensitivity and specificity for detecting lymph node metastases.
  • More robust long-term data from multicenter cohorts are necessary to establish optimal lymph node management in penile cancer.