[Localization of sentinel node in squamous cell carcinoma of the penis. Initial experience].
OBJECTIVE
To assess the validity of radioguided sentinel node biopsy in squamous cell penile carcinoma.


METHODS
Fifteen patients were studied. The first 5 patients were included in a group for validation of the technique, in which a standard inguinal lymphadenectomy was performed after the procedures described below. The remaining 10 patients were included in the technique application group. The day before surgery, lymphoscintigraphy was performed on all patients. During the operation, radioguided biopsy to locate the sentinel node was done. Methylene blue dye was injected shortly before surgery in 10 patients. All patients were followed for an average of 32 months.


RESULTS
In the validation group, lymphoscintigraphy revealed inguinal drainage in 5/5 patients. Unilateral metastases were detected in 3/5 patients. No metastatic nodes were detected among the nodes removed during inguinal lymphadenectomy. In the application group, lymphoscintigraphy showed inguinal drainage in 9/10 patients. Nineteen nodes were removed, none of which showed tumour involvement. During the follow-up period, no disease progression or recurrence were observed in either patient group.


CONCLUSIONS
Radioguided localization and biopsy of the sentinel nodes can avoid unnecessary lymphadenectomies in patients with squamous cell penile carcinoma and high or intermediate risk of lymph node involvement. This technique shows high reliability and negative predictive value in penile carcinoma.
Rubí
S
S
Servicio de Medicina Nuclear (CDIC), Hospital Clínic, Barcelona, Spain. srubi@clinic.ub.es
Vidal-Sicar
S
S
Ortega
M
M
Doménech
B
B
Lafuente
S
S
Corral
J M
JM
Gelabert-Mas
A
A
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D004396:Coloring Agents; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008751:Methylene Blue; D010412:Penile Neoplasms / Q000473:pathology*; D015642:Radiology, Interventional; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods* / Q000706:statistics & numerical data; D019564:Unnecessary Procedures
D004396:Coloring Agents; D008751:Methylene Blue