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Surgery

Is lymphadenectomy necessary for high-risk penile cancer?

Nature Reviews Urology volume 7, page 532 (2010)Cite this article

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The guidelines recommend inguinal lymphadenectomy for patients at high risk of occult metastasis; that is, those with pT2–pT4 and grade 3 disease, or evidence of lymphovascular invasion. Following an anecdotal observation that few such patients actually undergo the recommended procedure, Timothy Johnson and his US-based collaborators interrogated the Surveillance, Epidemiology and End Results (SEER) database.

Lymph nodes had been removed from just one-quarter of the 593 high-risk SEER-registered patients. Survival at 5 years was improved by excision of at least eight nodes. Johnson et al. conclude that better adherence to the EAU guidelines in the US would enhance patient outcomes.

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ORIGINAL RESEARCH PAPERS

  1. Johnson, T. V. et al. Extensive inguinal lymphadenectomy improves overall 5-year survival in penile cancer patients: results from the Surveillance, Epidemiology, and End Results program. Cancer 116, 2960–2966 (2010)

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  2. Graafland, N. M. et al. Prognostic factors for occult inguinal lymph node involvement in penile carcinoma and assessment of the high-risk EAU subgroup: a two-institution analysis of 342 clinically node-negative patients. Eur. Urol. doi:10.1016/j.eururo.2010.08.015

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  1. Rebecca Drake
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Drake, R. Is lymphadenectomy necessary for high-risk penile cancer?. Nat Rev Urol 7, 532 (2010). https://doi.org/10.1038/nrurol.2010.152

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