[Inguinal and pelvic lymph node dissection in penile cancer: indications, techniques, and trends]

Penile cancer is a rare disease that is associated with significant psychological and physical burdens. The pattern of metastasis in penile cancer is typically stepwise, starting from the inguinal lymph nodes, progressing to the pelvic lymph nodes, and eventually leading to distant metastases. Patient survival varies considerably: patients with a small number of regionally confined lymphatic metastases often have long-term survival prospects following surgical treatment, whereas advanced lymphatic metastasis is associated with a poorer prognosis. Current therapeutic strategies for patients with metastatic lymph node involvement aim to reduce morbidity related to radical inguinal lymphadenectomy, with appropriate risk stratification being essential to optimize oncological control and treatment success. This article discusses the current challenges of invasive lymph node management in patients with penile cancer.