Reliability and Safety of Current Dynamic Sentinel Node Biopsy for Penile Carcinoma

• Published in: European urology 2007-07, Vol.52 (1), p.170-177
• Main Authors: Leijte, Joost A.P, Kroon, Bin K, Valdés Olmos, Renato A, Nieweg, Omgo E, Horenblas, Simon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma - diagnostic imaging; Carcinoma - secondary; False Negative Reactions; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Inguinal Canal; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Penile Neoplasms - diagnostic imaging; Penile Neoplasms - pathology; Radionuclide Imaging; Reproducibility of Results; Retrospective Studies; Sentinel Lymph Node Biopsy - methods; Sentinel Lymph Node Biopsy - trends; Time Factors; Tumors; Urology
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2007.01.107

Abstract Objectives Dynamic sentinel node biopsy (DSNB) has been performed at our department since 1994 to assess status of inguinal lymph nodes of clinically node-negative (cN0) patients with penile carcinoma. Over time, several modifications were made to reduce the false-negative rate and thus increase sensitivity. We compared the false-negative and complication rates of the current procedure, as performed at our institute since 2001, with the prior procedures. Materials and methods The patients who underwent DSNB for penile carcinoma in the period from 1994 until July 2004 were divided into two cohorts: cohort A: patients treated from 1994 until 2001; cohort B: patients treated from 2001 until 2004. Cohort A consisted of 92 patients, in whom 157 groins were explored. Cohort B consisted of 58 patients, with a total of 105 explored groins. Medians for follow-up in cohorts A and B were 83 (range: 24–130) and 30 (range: 24–49) mo, respectively. The false-negative and complication rates were determined in both cohorts. Results In cohort A, 21 of 157 explored groins contained tumour-positive sentinel nodes, and five false-negative procedures were encountered, resulting in a false-negative rate of 19.2%. In cohort B, 20 of 105 explored groins contained tumour-positive sentinel nodes, and one procedure was false-negative. The false-negative rate was 4.8%. The rate of complications dropped from 10.2% in cohort A to 5.7% in cohort B. All complications were minor and transient. Conclusions The false-negative and complication rates of DSNB have decreased since the procedure was modified. The current procedure has false-negative and complication rates of 4.8% and 5.7%, respectively. DSNB has matured into a reliable and safe method for assessing status of lymph nodes in cN0 penile carcinoma patients.