Abstract
PurposeInguinal lymphadenectomy in penile cancer is associated with a high rate of wound complications. The aim of this trial was to prospectively analyze the effect of an epidermal vacuum wound dressing on lymphorrhea, complications and reintervention in patients with inguinal lymphadenectomy for penile cancer.Patients and methodsProspective, multicenter, randomized, investigator-initiated study in two German university hospitals (2013–2017). Thirty-one patients with penile cancer and indication for bilateral inguinal lymph node dissection were included and randomized to conventional wound care on one side (CONV) versus epidermal vacuum wound dressing (VAC) on the other side.ResultsA smaller cumulative drainage fluid volume until day 14 (CDF) compared to contralateral side was observed in 15 patients (CONV) vs. 16 patients (VAC), with a median CDF 230 ml (CONV) vs. 415 ml (VAC) and a median maximum daily fluid volume (MDFV) of 80 ml (CONV) vs. 110 ml (VAC). Median time of indwelling drainage: 7 days (CONV) vs. 8 days (VAC). All grade surgery-related complications were seen in 74% patients (CONV) vs. 74% patients (VAC); grade 3 complications in 3 patients (CONV) vs. 6 patients (VAC). Prolonged hospital stay occurred in 32% patients (CONV) vs. 48% patients (VAC); median hospital stay was 11.5 days. Reintervention due to complications occurred in 45% patients (CONV) vs. 42% patients (VAC).ConclusionsIn this prospective, randomized trial we could not observe a significant difference between epidermal vacuum treatment and conventional wound care.
Highlights
Penile cancer is a rare disease with an incidence of 1/100.000/year in Europe, with an age peak around the sixth decade
Invasive penile cancer is an aggressive disease with a high risk of metastasis, with local treatment adapted to tumor extension [1]
We present the results of a prospective, randomized trial to analyze the effect of epidermal vacuum therapy on wound complications after inguinal lymphadenectomy in patients with penile cancer
Summary
Penile cancer is a rare disease with an incidence of 1/100.000/year in Europe, with an age peak around the sixth decade. Invasive penile cancer is an aggressive disease with a high risk of metastasis, with local treatment adapted to tumor extension [1]. Even in the case of clinically normal inguinal lymph nodes, the risk for micrometastasis is around 25% in patients with intermediate or high-risk penile cancer (≥ pT1 G2). In these patients, a surgical lymph node staging is recommended using inguinal lymphadenectomy [2]. A surgical lymph node staging is recommended using inguinal lymphadenectomy [2] It can be performed either as dynamic sentinel node biopsy or as modified (limited) inguinal lymphadenectomy. In patients with clinically suspicious (palpable or visible) inguinal lymph
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