title: Dynamic sentinel node biopsy in clinically node-negative penile cancer versus radical inguinal lymphadenectomy: a comparative study.
abstract: OBJECTIVE
  To evaluate the reliability and morbidity of dynamic sentinel node biopsy compared with radical inguinal lymphadenectomy (RIL) in the treatment of selected patients with squamous cell penile carcinoma.
  
  
  METHODS
  We retrospectively considered patients with clinically node-negative Stage pT2-pT3 penile cancer. From 1994 to 2000, 48 patients (group 1, mean age 63 years) underwent penectomy and, after 4 weeks, prophylactic bilateral RIL. From 2001 to 2004, 22 patients (group 2, mean age 67 years) underwent penectomy and dynamic sentinel node biopsy. After 4 weeks, bilateral RIL was performed.
  
  
  RESULTS
  In group 1, nodal disease was found in 39.6% of the patients. Early complications occurred in 21 patients (47.5%), with the most common being seroma formation. Late complications occurred in 18 patients (37.5%), with the most common being leg edema. In group 2, preoperative lymphoscintigraphy revealed no sentinel nodes in 1 patient, unilateral sentinel nodes in 7, and bilateral nodes in 14. A total of 35 sentinel nodes were seen in 42 inguinal regions (mean 0.83), including 27 (77.2%) identified with the probe and blue dye and 8 (22.8%) located with the probe only. Metastases were noted in 8 (36.4%) of 22 patients, bilaterally in 4 of them. Early minor complications occurred in 3 patients (13.6%). The technique had an 89% negative predictive value and 90% sensitivity.
  
  
  CONCLUSIONS
  The results of this study have shown that dynamic sentinel node biopsy is a minimally invasive technique that is easy to perform, with similar results to those of RIL, but lower morbidity. This procedure offers the possibility of less-extensive surgery for clinically node-negative penile carcinoma.
authors.affiliation: Department of Urology, National Cancer Institute, Naples, Italy.
authors.forename: Sisto
authors.initials: S
authors.lastname: Perdonà
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
authors.forename: Marco
authors.initials: M
authors.lastname: De Sio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Lorenzo
authors.forename: Luigi
authors.initials: L
authors.lastname: Gallo
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.forename: Massimo
authors.initials: M
authors.lastname: D'Armiento
authors.forename: Antonio
authors.initials: A
authors.lastname: Gallo
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods