title: [Dynamic sentinel node biopsy in penile cancer. Indications, technique and results in a Spanish oncological center].
abstract: OBJECTIVE
  Penile cancer has a predominantly lymphatic dissemination. Lymph nodes metastatic involvement conditions disease prognosis and inguinal lymph node dissection has both prognostic and therapeutic value. High and intermediate risk patients with non-palpable lymph nodes will benefit of a precise diagnosis by means of selective sentinel node biopsy with minimal surgical aggressiveness.
  
  
  METHODS
  Retrospective review of our experience on dynamic sentinel node biopsy in penile cancer from November 1999 to July 2014.
  
  
  RESULTS
  We performed this procedure in 33 patients, technically successful in 29 (88%). The patients who did not undergo lymph node dissection due to positive sentinel node biopsy have been followed a mean of 60.4 months (Median 59, range 5-145). 20 patients underwent simultaneous sentinel node biopsy and surgical treatment of the primary lesion and in 13 it was performed posteriorly. In these cases the time lapse was 5.5 months (median 5, range 2-12). In 6 (18.9%) of the 29 patients successfully biopsied, metastasis was founded in any of the lymph nodes identified as sentinel. Two patients were false negative (6,25%). Sensitivity (S), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of successfully performed sentinel node biopsies were 66, 100, 100 and 93%, respectively.
  
  
  CONCLUSIONS
  Sentinel node biopsy enables a correct lymph node staging avoiding the morbidity of inguinal lymph node dissection. The rate of technical failure and false negative results is low and it may be considered the diagnostic technique of choice in high and intermediate risk penile cancer with non-palpable lymph nodes.
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Gómez-Ferrer
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: José
authors.initials: J
authors.lastname: Rubio
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Argimiro
authors.initials: A
authors.lastname: Collado
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Juan
authors.initials: J
authors.lastname: Casanova
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: José
authors.initials: J
authors.lastname: Domínguez
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ramírez
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Ricós
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Monrós
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Raimundo
authors.initials: R
authors.lastname: Dumont
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Iborra
authors.affiliation: Servicio de Urología. Instituto Valenciano de Oncología. Valencia. España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Solsona
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002173:Cancer Care Facilities; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013030:Spain