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Lymph Node Mapping in Patients with Penile Cancer Undergoing Pelvic Lymph Node Dissection.
Kai Yao1,2,3, Yue Chen1,2,4, Yunlin Ye1,2,3
1Key Laboratory of Oncology in Southern China, Guangzhou, China.
The Journal of Urology
|August 7, 2020
Summary
Penile cancer metastasis commonly involves external iliac and obturator lymph nodes. Optimal pelvic lymph node dissection should include these areas and extend to the common iliac artery for comprehensive treatment.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Pelvic lymph node metastasis patterns in penile cancer are not well-established.
- Understanding these patterns is crucial for defining appropriate surgical dissection limits.
Purpose of the Study:
- To map pelvic lymph node metastasis in penile cancer patients.
- To determine optimal extent for pelvic lymph node dissection.
Main Methods:
- Retrospective analysis of 128 penile cancer patients undergoing pelvic lymph node dissection (1999-2018).
- Recorded numbers of retrieved and positive lymph nodes across 10 regions.
- Statistical analysis using chi-square and Fisher exact tests.
Main Results:
- External iliac (43.0%) and obturator (31.9%) nodes were most frequently retrieved.
- 44.5% of patients had pelvic lymph node metastasis, predominantly in external iliac (50.0%) and obturator (36.6%) nodes.
- Higher T-stage correlated with increased metastasis risk; crossover metastasis observed in 2 patients.
Conclusions:
- A detailed map of penile cancer pelvic lymph node metastasis is presented.
- External iliac and obturator lymph node packages are primary sites of metastasis.
- Optimal dissection should encompass common iliac, external iliac, internal iliac, and obturator nodes.
