Modified technique of radical inguinal lymphadenectomy for penile carcinoma: morbidity and outcome.
OBJECTIVE
Classic radical inguinal lymphadenectomy is associated with significant morbidity. Modified inguinal lymphadenectomy has been used to decrease the complication rate but it may compromise the oncological effect and depends on the use of intraoperative frozen sections, which may be inaccurate. We modified the technique of radical inguinal lymphadenectomy to decrease postoperative complications without compromising oncological effectiveness.


METHODS
We performed 150 modified radical inguinal dissections in 75 patients with penile carcinoma from February 1999 to September 2008. Patients underwent modified radical inguinal dissection characterized by an S-shaped incision, precisely separating layers using an anatomical landmark and preserving the fascia lata. The boundaries of dissection are the same as those of radical inguinal lymphadenectomy. Survival and morbidity data were retrospectively analyzed, and survival probabilities were calculated.


RESULTS
Followup ranged from 12 to 113 months. Overall 3-year survival was 92%, and for N0, N1, N2 and N3 disease it was 100%, 100%, 85% and 57.1%, respectively. A total of 37 complications occurred including wound infection (1.4%), skin necrosis (4.7%), lymphedema (13.9%), seroma (2.0%), lymphocele (2.0%) and deep venous thrombosis (0.7%).


CONCLUSIONS
Morbidity related to groin dissection in patients with penile carcinoma can be decreased and oncological effectiveness can be preserved using this modified inguinal dissection technique.
Yao
Kai
K
Department of Urology, Cancer Center, Sun Yat-Sen University and State Key Laboratory of Oncology in Southern China, Guangzhou, PR China.
Tu
Hua
H
Li
Yong-Hong
YH
Qin
Zi-Ke
ZK
Liu
Zhuo-Wei
ZW
Zhou
Fang-Jian
FJ
Han
Hui
H
D000328:Adult; D000368:Aged; D006801:Humans; D007264:Inguinal Canal; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult