title: Feasibility, complications and oncologic results of a limited inguinal lymph node dissection in the management of penile cancer.
abstract: OBJECTIVE
  In patients with penile cancer (PeCa) and increased risk of inguinal lymphatic dissemination, inguinal lymphadenectomy offers a direct histological staging as the most reliable tool for assessment of the nodal metastasic status and a definitive oncologic treatment simultaneously. However, peri- and/or postoperative mutilating sequalae often occurn. We report on clinical outcome and complications of a limited inguinal lymph node (LN) dissection.
  
  
  METHODS
  Clinical and histopathological data of all patients with PeCa who underwent limited inguinal lymphadenectomy (LIL) at our institution between 1986 and 2012 were comprehensively analyzed. Perioperative results were presented in relation to one-sided procedures, if appropriate, which were assessed without cross comparison with contralateral LILs.
  
  
  RESULTS
  29 consecutive patients with PeCa aged 60±10.3 years were included in the current study with 57 one-sided LIL performed. Mean operative time for one-sided LIL was 89.0±37.3 minutes with 8.1±3.7 LNs removed. A complication rate of 54.4% (n=31), including 16 minor and 15 major complications was found in a total of 57 procedures with leg oedema being the most prevalent morbidity (15.8%). 4 patients with clinically positive LNs developed inguinal lymphatic recurrence within 9 months after surgery.
  
  
  CONCLUSIONS
  Our technique of limited inguinal LN dissection provided an acceptable complication rate without aggravating morbidity. We experienced no recurrences in clinically LN negative patients, so that the approach might be a reasonable option in this scenario. In patients with enlarged LNs, radical inguinal lymphadenectomy still appears to represent the gold standard.
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Igor
authors.initials: I
authors.lastname: Tsaur
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: Biegel
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Kilian
authors.initials: K
authors.lastname: Gust
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Huesch
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Borgmann
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Maximilian P J K
authors.initials: MP
authors.lastname: Brandt
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Kurosch
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Reiter
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Schilling
authors.affiliation: Department of Urology and Pediatric Urology, Goethe-University, Frankfurt am Main, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Haferkamp
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D061646:Operative Time; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D059035:Perioperative Period; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden