Controversies concerning lymph node dissection for cancer of the penis

Cancer of the penis represents one of the two genital cancers (testis cancer is the other) in which cure may frequently be effected in the presence of lymph node metastases. The questions that are raised include if and when therapeutic or prophylactic lymphadenectomy is indicated. Extended node dissection is governed, to an extent, by recognition of the seriousness of pelvic node involvement and by uncertainty regarding the status of the contralateral side with proof of disease on one side. The sentinel node theory, with its potential impact on the possible approach to these problems, must be confirmed or denied before our present therapeutic philosophy is modified.