title: Inguinal Lymph Nodes in Carcinoma Penis-Observation or Surgery?
abstract: BACKGROUND
  In Indian sub-continent the presentation of carcinoma penis is variable. Mostly presents with palpable inguinal lymph nodes but not confirm of metastases.
  
  
  OBJECTIVE
  To evaluate whether all clinically positive nodes are metastatic and decide when to address inguinal lymph node.
  
  
  METHODS
  A retrospective observational study on carcinoma penis from a regional cancer centre of south India over a period from 2001 to 2012. All the clinical, investigational, operative, pathology details and follow-up data were collected from patient records.
  
  
  RESULTS
  Two hundred and thirty cases of carcinoma penis have been identified and 112 cases had clinically positive nodes. In 74 cases fine needle cytology was positive for malignancy and they have been addressed with block dissection with surgery of primary lesion. At two years follow up, 70 patients were identified with inguinal lymph node metastasis and block dissection was performed and all was were positive for malignancy on histology. The rate of recurrence is related to the T stage of the primary tumour.
  
  
  CONCLUSIONS
  It can be concluded that elective surgery is appropriate for palpable inguinal lymph nodes and prophylactic nodal dissection in high risk cases of carcinoma penis.
authors.affiliation: Associate Professor, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology , Bangalore, India .
authors.forename: Syed
authors.initials: S
authors.lastname: Althaf
authors.affiliation: Assistant Professor, Department of General Surgery, Bangalore Medical College and Research Institute , Bangalore, India .
authors.forename: Rajkumar P
authors.initials: RP
authors.lastname: Narayanakar
authors.affiliation: Assistant Professor, Department of General Surgery, Kempegowda Medical College , Bangalore, India .
authors.forename: Dinesh M
authors.initials: DM
authors.lastname: Gangaiah
authors.affiliation: Resident, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology , Bangalore, India .
authors.forename: Kapil
authors.initials: K
authors.lastname: Dev
authors.affiliation: Resident, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology , Bangalore, India .
authors.forename: Vishnu P
authors.initials: VP
authors.lastname: Kurpad
authors.affiliation: Resident, Department of Surgical Oncology, Kidwai Memorial Institute of Oncology , Bangalore, India .
authors.forename: Jaiprakash
authors.initials: J
authors.lastname: Gurawalia
keywords: Inguinal metastasis; Penile cancer