title: Fluorescence diagnosis: a novel method to guide radical inguinal lymph node dissection in penile cancer.
abstract: In penile cancer there is still a diagnostic dilemma between over treatment of lymph node-negative patients and the missing of occult metastases by watchful waiting. In the current study the value of fluorescence diagnosis during radical inguinal lymph node dissection was evaluated. Five patients with penile cancer were elected to undergo groin dissection. All patients received 5-aminolevulinic acid (5-ALA) orally before the operation for fluorescence diagnosis. Intraoperatively, fluorescence detection of the lymph nodes was performed by visual detection and spectroscopy. Two of the five patients had positive inguinal lymph nodes. Fluorescence in tumor-bearing tissue was detectable in the exposed lymph nodes. Protoporphyrin IX (PPIX) is accumulated in tumor-positive lymph nodes, making fluorescence diagnosis in penile cancer possible. More studies with higher patient numbers are necessary to evaluate optimal dosage and excitation conditions to detect tumor-bearing nodes in vivo.
authors.affiliation: Department of Urology, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany. frimberger@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Frimberger
authors.forename: R
authors.initials: R
authors.lastname: Linke
authors.forename: H
authors.initials: H
authors.lastname: Meissner
authors.forename: H
authors.initials: H
authors.lastname: Stepp
authors.forename: D
authors.initials: D
authors.lastname: Zaak
authors.forename: E
authors.initials: E
authors.lastname: Hungerhuber
authors.forename: R
authors.initials: R
authors.lastname: Waidelich
authors.forename: N
authors.initials: N
authors.lastname: Schmeller
authors.forename: A
authors.initials: A
authors.lastname: Hofstetter
authors.forename: P
authors.initials: P
authors.lastname: Schneede
mesh_terms: D005453:Fluorescence; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D010412:Penile Neoplasms / Q000473:pathology* / Q000601:surgery*; D011524:Protoporphyrins
chemical_list: D011524:Protoporphyrins; C028025:protoporphyrin IX