MP40-17 INGUINAL LYMPHADENECTOMY USING A FASCIAL SPARING TECHNIQUE IN THE MANAGEMENT OF PENILE CANCER – TECHNIQUE AND OUTCOMES FROM A SINGLE CENTRE

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer I (MP40)1 Sep 2021MP40-17 INGUINAL LYMPHADENECTOMY USING A FASCIAL SPARING TECHNIQUE IN THE MANAGEMENT OF PENILE CANCER – TECHNIQUE AND OUTCOMES FROM A SINGLE CENTRE Nicolo' Schifano, Fabio Castiglione, Matthew Rewhorn, Axel Cayetano-Alcaraz, Paul Hadway, Raj Nigam, Rowland Rees, Hussain M. Alnajjar, and Asif Muneer Nicolo' SchifanoNicolo' Schifano More articles by this author , Fabio CastiglioneFabio Castiglione More articles by this author , Matthew RewhornMatthew Rewhorn More articles by this author , Axel Cayetano-AlcarazAxel Cayetano-Alcaraz More articles by this author , Paul HadwayPaul Hadway More articles by this author , Raj NigamRaj Nigam More articles by this author , Rowland ReesRowland Rees More articles by this author , Hussain M. AlnajjarHussain M. Alnajjar More articles by this author , and Asif MuneerAsif Muneer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002055.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical inguinal lymphadenectomy is performed for penile cancer patients who have pN+ disease in the inguinal lymph nodes. In order to reduce the morbidity, modified approaches have been described to reduce the size of the incision or reduce the number of lymph nodes removed. We describe the technique and report the oncological outcomes and complication rates of a fascial sparing inguinal lymphadenectomy technique. METHODS: Over a 10 year period, 294 fascial sparing inguinal lymphadenectomy procedures were performed in 173 patients. The technique used a subinguinal incision with an ellipse of skin excised over any palpable nodes. Identification and preservation of the Scarpa’s and Camper’s fascia was the first fascial preservation. All superficial inguinal nodes were removed en bloc under this fascial layer whilst preserving the subcutaneous veins and fascia lata. The saphenous vein was spared where possible as part of the standard technique. Kaplan-Meier curves estimated the survival functions after the procedure. Postoperative morbidity was also retrospectively analysed. RESULTS: Median (interquartile range, IQR) follow-up was 28 (14-90) months. A median (IQR) number of 9 (6-12) nodes were removed per groin. The 3-year cancer-specific survival rate was 84% for pN1, and 56% for pN2-3 disease (p<0.001) compared to 91% for pN0 cases (Figure 1). A total of 105 postoperative complications (35.7%) occurred, including 46 conservatively-managed wound infections (15.6%), 13 cases of deep wound dehiscence (4.4%), 41 cases of lymphoedema (13.9%), 3 cases of deep vein thrombosis (1.0%), 1 case of pulmonary embolism (0.3%), and 1 case of postoperative sepsis (0.3%). CONCLUSIONS: Fascial sparing inguinal dissection offers excellent oncological outcomes whilst decreasing the morbidity rates. Patients with more advanced nodal-involvement had poorer survival rates, emphasizing the need to evaluate the possible role of adjuvant chemo-radiotherapy protocols in these settings. Source of Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e721-e721 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicolo' Schifano More articles by this author Fabio Castiglione More articles by this author Matthew Rewhorn More articles by this author Axel Cayetano-Alcaraz More articles by this author Paul Hadway More articles by this author Raj Nigam More articles by this author Rowland Rees More articles by this author Hussain M. Alnajjar More articles by this author Asif Muneer More articles by this author Expand All Advertisement Loading ...