Morbidity of prophylactic inguinal lymphadenectomy with saphenous vein preservation for squamous cell penile carcinoma

Abstract

Inguinal lymphadenectomy has an essential role in the cure of patients with inguinal metastasis from penile cancer; however, this procedure is associated with a significant morbidity. In recent years, modified lymphadenectomy with saphenous vein preservation has been postulated to reduce morbidity. Herein, we present our recent experience with prophylactic inguinal lymhadenectomy and saphenous vein preservation in patients with invasive penile carcinoma and non-palpable inguinal lymph nodes. Seven patients with invasive squamous cell penile carcinoma, who underwent bilateral prophylactic inguinal lymphadenectomy with saphenous vein preservation between 1995 and 2001, were reviewed retrospectively. Mean age was 67.7 years. The pathological stage of the primary tumor was pT2 in four and pT3 in three patients respectively. Postoperative complications were defined as minor--wound infection, seroma formation requiring drainage, and skin necrosis, and major-- deep venous thrombosis, persistent seroma formation, flap necrosis requiring a skin graft, as well as permanent and disabling leg lymphedema. Minimum follow up was 2 years. Minor complications--wound infection--occurred in one patient (one groin). No major complications occurred. All patients are alive without evidence of disease recurrence. Prophylactic inguinal lymphadenectomy seems to offer reduced morbidity in high risk penile cancer patients without compromising survival outcome.