title: Sentinel node biopsy and lymphatic mapping in penile and prostate cancer.
abstract: BACKGROUND
  Nodal metastases are linked to poor outcome in men with penile or prostate cancer. Early detection and resection are important for staging and for the prognosis. However, lymphadenectomy is associated with morbidity and may miss metastases when performed solely on the basis of anatomical templates.
  
  
  METHODS
  In this article we describe the technique and benefits of sentinel node biopsy (SNB) and provide a review of the literature.
  
  
  RESULTS
  Dynamic sentinel node techniques using both radioactive and optical (hybrid) tracers have been proven effective in penile cancer. For prostate cancer, SNB added to extended nodal dissection may further tailor dissection to the highly variable lymphatic drainage patterns in the pelvis. The sensitivity of SNB was found to be superior to conventional imaging methods; however, false-negative SNB procedures can occur and a complementary extensive lymphadenectomy is required to remove additional positive nodes that were not detected in the SNB template.
  
  
  CONCLUSIONS
  SNB is a standard method for early detection of nodal metastases in penile cancer and provides superior diagnostic accuracy to conventional imaging modalities in prostate cancer.
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. h.vd.poel@nki.nl.
authors.forename: H G
authors.initials: HG
authors.lastname: van der Poel
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Meershoek
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Grivas
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: KleinJan
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: F W B
authors.initials: FW
authors.lastname: van Leeuwen
authors.affiliation: Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D010412:Penile Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D000072098:Single Photon Emission Computed Tomography Computed Tomography / Q000379:methods*
keywords: Lymphadenectomy; Penile cancer; Prostate cancer; Review; Sentinel lymph node biopsy