P0126 Role of dynamic sentinel lymph node biopsy in carcinoma of the penis with or without palpable nodes

Abstract

Background We sought to evaluate the role of dynamic sentinel node biopsy in patients diagnosed with carcinoma of the penis and clinically N0 disease, using superficial inguinal dissection as the standard staging modality. Methods 20 consecutive men (40 groins) with penis carcinoma having clinically N0 status were enrolled. Patients underwent dynamic sentinel node biopsy with injection of radiocolloid and blue dye if FNAC from the groin nodes was negative. The sentinel lymph nodes were harvested. The inguinal incision was then extended and a modified superficial inguinal dissection was performed and all nodes were labelled separately and sent for frozen section. A complete deep inguinal pelvic dissection was done if any of the nodes were reported positive for malignancy. Findings Median age was 52.5 years. Ten patients were smokers. Phimosis was present in five patients. Lesions were present over the glans penis and shaft in 18 and two patients, respectively. Wide local excision, partial penectomy, and total penectomy were done in one, 15 patients, and four patients, respectively. Clinically palpable nodes were found in 19 groins. Median follow-up was 26 months. Nodes were positive in ten groins. Dynamic sentinel node biopsy missed the sentinel lymph node in one groin. The accuracy and false negative rate of dynamic sentinel node biopsy were 97.5% and 10%, respectively. Interpretation Dynamic sentinel node biopsy is a useful and reliable technique to identify the involved nodes in patients diagnosed with carcinoma of the penis with clinical N0 status (with or without palpable nodes). The technique reduces morbidity associated with a staging inguinal dissection in these patients.