975 ADVANTAGES OF DYNAMIC SENTINEL LYMPHNODE BIOPSY TECHNIQUE IN THE MANAGEMENT OF PENILE CANCER

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011975 ADVANTAGES OF DYNAMIC SENTINEL LYMPHNODE BIOPSY TECHNIQUE IN THE MANAGEMENT OF PENILE CANCER Akos Pytel, Miklos Damasdi, Erzsebet Schmidt, Agnes Frick, and Laszlo Farkas Akos PytelAkos Pytel Pecs, Hungary More articles by this author , Miklos DamasdiMiklos Damasdi Pecs, Hungary More articles by this author , Erzsebet SchmidtErzsebet Schmidt Pecs, Hungary More articles by this author , Agnes FrickAgnes Frick Pecs, Hungary More articles by this author , and Laszlo FarkasLaszlo Farkas Pecs, Hungary More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.986AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Controversies persist over the therapeutic approach to low and medium risk penile carcinoma, particularly in patients with clinically negative inguinal nodes. Dynamic scintigraphy for the identification of a sentinel node and screening of subclinical metastasis seems to be a reliable method according to data published recently. Several studies have described a positive association between positivity of lymph nodes evaluated, and prognosis for penile cancer patients and also a large variation in the number of lymph nodes examined between departments of pathology, hospitals, regions, and countries. This variation may lead to miss potentially metastatic sentinel nodes which influence staging and subsequent therapy. The aim of this paper is to present our experience with dynamic sentinel node biopsy (DSNB) with intraoperative gamma ray detection probe, and to demonstrate the advantege of this technique helping pathological practice pattern. METHODS 36 patients with clinically node negative penile cancer were entered in this study. Preoperative lymphoscintigraphy was performed after intradermal injection of 99mtechnetium nanocolloid around the primary tumor. The sentinel node was intraoperatively identified with the aid of a gamma ray detection probe. Radical inguinal et pelvic lymphnode dissections were performed if metastasis were found with DSNB. No additional lyphadenectomy was performed in case of histological negative sentinel node status. In five high risk patient inguinal lymphadenectomy was performed without DSNB, but the sentinel nodes were identified with gamma ray probe and marked in the sample sent to the pathology. RESULTS Lymphoscintigraphy visualized 68 sentinel nodes of 36 patients. All sentinel nodes were intraoperatively identified and removed. Sentinel node metastasis was found in 4 patients. In these four patients the additional radical lymphadenectomy proved no further metastasis in two cases. In two cases patients developed metastasis in more lymphnodes. Regional or distant recurrence after excision of a tumor negative sentinel node was not observed in a median follow up of 23 months (range 4 to 42). No major complication did occur after sentinel node biopsy. In the five patients underwent elective lymphadenectomy, the marked sentinel nodes were easily evaluable by the pathologist, and in one case occult metastasis was diagnosed. CONCLUSIONS DSNB is reliable and safe method with low morbidity in the detection of occult metastasis of low and medium risk penile cancer, and may help diagnostic accuracy in high risk patients as well. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e393 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Akos Pytel Pecs, Hungary More articles by this author Miklos Damasdi Pecs, Hungary More articles by this author Erzsebet Schmidt Pecs, Hungary More articles by this author Agnes Frick Pecs, Hungary More articles by this author Laszlo Farkas Pecs, Hungary More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...