title: Prophylactic lymphadenectomy vs observation vs inguinal biopsy in node-negative patients with invasive carcinoma of the penis.
abstract: From 1962 to 1984, 423 patients with invasive penile cancer and negative groin nodes were subjected to prophylactic lymphadenectomies (n113), observations (n258) or inguinal biopsies (n52) in a non-randomised fashion. The numbers of patients with T2, T3 and T4 lesions were similar in the three groups. The overall five-year disease-free survivals were 94, 93 and 85%, respectively. All groin recurrences in the observation group occurred within 18 months of the surgery for the primary tumor. The five-year disease-free survivals of node-positive patients in the lymphadenectomy and observation groups were 100 and 76%, respectively; three patients in the latter group had refused surgical treatment when their adenopathy was mobile. Morbidity from the prophylactic lymphadenectomies included wound breakdown in 61%, wound infection in 18% and lymphedema in 25% of patients. We feel that neither prophylactic lymphadenectomy nor inguinal biopsy are justified in these patients. Close observation of the groin nodal status would be appropriate.
authors.affiliation: Department of Genitourinary Surgery, Cancer Institute (WIA), Madras, India.
authors.forename: R
authors.initials: R
authors.lastname: Ravi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate