title: DaPeCa-1: diagnostic accuracy of sentinel lymph node biopsy in 222 patients with penile cancer at four tertiary referral centres - a national study from Denmark.
abstract: OBJECTIVE
  To estimate the diagnostic accuracy of sentinel lymph node biopsy (SNB) in patients with penile cancer and assess SNB complications in a national multicentre setting.
  
  
  METHODS
  Retrospectively data were collected from records in four university centres by one medical doctor covering all SNBs performed in Denmark between 1 January 2000 and 31 December 2010. Patients had either impalpable lymph nodes (LNs) in one or both groins, or had a palpable inguinal mass from which aspiration cytology failed to reveal malignancy. Patients were injected with nanocolloid technetium and had a scintigram recorded before the SNB. The primary endpoint was LN recurrence on follow-up. The secondary endpoint was complications after SNB. Diagnostic accuracy was computed.
  
  
  RESULTS
  In all, 409 groins in 222 patients were examined by SNB. The median (interquartile range) follow-up of patients who survived was 6.6 (5-10) years. Of 343 negative groins, eight were false negatives. The sensitivity was 89.2% (95% confidence interval 79.8-95.2%) per groin. Interestingly, four of 67 T1G1 patients had a positive SNB. In all, 28 of 222 (13%) patients had complications of Clavien-Dindo grade I-IIIa.
  
  
  CONCLUSIONS
  Penile cancer SNB with a close follow-up stages LN involvement reliably and has few complications in a national multicentre setting. Inguinal LN dissection was avoided in 76% of patients.
authors: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors: Jakob K
authors: JK
authors: Jakobsen
authors: Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Kim P
authors: KP
authors: Krarup
authors: Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Peter
authors: P
authors: Sommer
authors: Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Henrik
authors: H
authors: Nerstrøm
authors: Department of Plastic Surgery, Odense University Hospital, Odense, Denmark.
authors: Vivi
authors: V
authors: Bakholdt
authors: Department of Plastic Surgery, Odense University Hospital, Odense, Denmark.
authors: Jens A
authors: JA
authors: Sørensen
authors: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors: Kasper Ø
authors: KØ
authors: Olsen
authors: Department of Urology, Herlev University Hospital, Herlev, Denmark.
authors: Bjarne
authors: B
authors: Kromann-Andersen
authors: Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Birgitte G
authors: BG
authors: Toft
authors: Department of Pathology, Aarhus University Hospital, Aarhus, Denmark.
authors: Søren
authors: S
authors: Høyer
authors: Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Aarhus, Denmark.
authors: Kirsten
authors: K
authors: Bouchelouche
authors: Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
authors: Jørgen B
authors: JB
authors: Jensen
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology*; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D062606:Tertiary Care Centers; D016896:Treatment Outcome
keywords: lymph node staging; multicentre; penile cancer; sensitivity; sentinel node; squamous cell carcinoma of the penis