Sentinel lymph node biopsy in penile cancer: a comparative study using modified inguinal dissection

ABSTRACT

INTRODUCTION: In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile cancer and at least one negative inguinal region. MATERIALS AND METHODS: In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. RESULTS: The mean age of the study sample was 57.7 years (44 - 81 years) and the sentinel lymph node presented 0 percent false negative 66 percent sensitivity, and 79.3 percent specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment. CONCLUSION: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions. However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers.