title: [Long-term results of sentinel node biopsy diagnostics in penile carcinoma : Dynamic sentinel node biopsy in cases with nonpalpable lymph nodes in the groin].
abstract: OBJECTIVE
  Dynamic sentinel node biopsy (DSNB) has been recommended in the EAU guidelines for several years as a minimally invasive method for lymph node staging in patients with penile carcinoma and nonpalpable lymph nodes. However, due to the high methodological demands and the primarily unreliable results, this method is rarely used in Germany. The aim of this study was to establish the reliability and morbidity of this method.
  
  
  METHODS
  The frequency of lymph node recurrent disease and complications were prospectively recorded in patients with initially nonpalpable inguinal lymph nodes and histologically negative sentinel lymph nodes. Quality criteria were the false negative rate (percentage of lymph node recurrence in negative procedures) and the morbidity rate. Inguinal regions with palpable lymph nodes and/or evidence of metastases were not considered.
  
  
  RESULTS
  The study included 37 patients with histologically negative sentinel lymph nodes in 63 groins with nonpalpable inguinal lymph nodes. There were 21 T1(a/b) stages, 10 T2, and 6 T3 stages. Tumor differentiation was good in 4, moderate in 26, and poor in 7 patients. During a median follow-up of 52 months (range 1-131 months), we observed a bilateral lymph node recurrence in 1 patient and a conservatively managed prolonged lymphorrhea in another patient. Per inguinal region the false-negative rate was 3.2 % and the morbidity rate was 1.6 %; seen per patient the rates were both 2.7 %.
  
  
  CONCLUSIONS
  DSNB is a reliable method of lymph node staging in patients with penile carcinoma and nonpalpable inguinal lymph nodes. The high degree of reliability in combination with the low morbidity justifies the higher methodical complexity of this method.
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland. CarstenMaik.Naumann@uksh.de.
authors.forename: C M
authors.initials: CM
authors.lastname: Naumann
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Bothe
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: A-K
authors.initials: AK
authors.lastname: Munk-Hartig
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: van der Horst
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Massad
authors.affiliation: Klinik für Nuklearmedizin, Molekulare Bilddiagnostik und Therapie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Kiel, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Lützen
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: K-P
authors.initials: KP
authors.lastname: Jünemann
authors.affiliation: Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig Holstein, Campus Kiel, Arnold Heller Straße 3 (Haus18), 24105, Kiel, Deutschland.
authors.forename: M F
authors.initials: MF
authors.lastname: Hamann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005188:False Negative Reactions; D005500:Follow-Up Studies; D006119:Groin; D019983:Guideline Adherence; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D011446:Prospective Studies; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D000072098:Single Photon Emission Computed Tomography Computed Tomography
keywords: Carcinoma, invasive; Lymphorrhea; Metastasis; Neoplasm recurrence, local; Neoplasm staging