Inguinal lymph node dissection for penile carcinoma: Postoperative complications using a validated classification system.

Abstract

326 Background: Inguinal lymph node dissection (ILND) is the gold standard for evaluating for locoregional disease in penile squamous cell carcinoma (PSCC), however, it has been previously described to have a high morbidity rate. We describe our postoperative complications using a validated classification system and examine possible associations with clinicopathologic factors. Methods: We retrospectively identified patients with a diagnosis of PSCC that underwent ILND at our institution from 1995 to 2012. Postoperative complications were characterized by the highest grade complication achieved by patients using the Clavien-Dindo classification system during the first 90 days after their surgery. Clavien-Dindo scores of 2 or less were defined as low grade, and scores of 3 or greater were defined as high grade. Univariate Cox regression analysis was performed to examine associations between complications and clinicopathologic factors. Results: We identified 36 patients who underwent ILND during this period, with 29 that had complete clinical, pathological and complication data. For the 50 ILNDs performed in our cohort, we report a 46% total complication rate, with a 36% low grade and a 10% high grade complication rate. Of the low grade complications, 39% were wound dehiscences that required wound packing, and 28% were wound infections that required antibiotic treatment. The highest grade of complications achieved was 3A, all of which were lymphoceles that required percutaneous drainage for resolution. We were unable to demonstrate any association of complications with age, ethnicity, tumor stage, tumor grade, AJCC stage, presence of palpable lymphadenopathy or pathologic nodal stage. Conclusions: While ILND still remains an operation with high morbidity, our findings show that the most common low grade complications can be managed with medications and dressing changes, and the relatively modest high grade complication rate consists entirely of percutaneous drain placement. The inability to show associations with clinicopathologic variables is likely due to our low sample size. These findings support the continued use of ILND for staging in PSCC.