[Controversies over regional lymphadenectomy in carcinoma of the penis].
Epidermoid carcinoma of the penis, although rare, is a very aggressive tumor type. The presence or absence of inguinal metastasis is an essential prognostic factor. Treatment of these metastases is one of the current controversies in urological practice; i.e., when and to what extent lymphadenectomy should be performed. Of 24 patients with penile carcinoma, 10 had undergone regional lymphadenectomy over the past 8 years at our institution. Following treatment of the primary penile tumor, 6 patients had palpable inguinal nodes that persisted after treatment with antibiotic and antiinflammatory agents for 6 weeks. Of these, 3 had a positive node biopsy. They were submitted to regional lymphadenectomy which revealed node metastasis in 5 cases (2 pN3, 2 pN2 and 1 pN1). The patients with no palpable nodes were closely followed and were submitted to lymphadenectomy when these appeared (3 cases). The fatal outcome of 2 cases (both pN3) prompted us to perform lymphadenectomy prophylactically in the last case, a 40-year-old male with pT2G2 N0 penile cancer. This approach is advocated in patients under 65 with invasive penile carcinoma (pT greater than 1) or a high histological grade of malignancy (G2 and G3).
Cózar Olmo
J M
JM
Servicio de Urología, Hospital La Paz, Facultad de Medicina, Universidad Autónoma, Madrid, Espanña.
Navarro
J
J
de la Peña
J
J
Cisneros
J
J
Cárcamo Valor
P
P
García-Matres
M J
MJ
Martínez-Piñeiro
L
L
Martínez-Piñeiro
J A
JA
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D015994:Incidence; D007264:Inguinal Canal; D008197:Lymph Node Excision / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D010412:Penile Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D016019:Survival Analysis
Controversias sobre la linfadenectomía regional en el carcinoma de pene.