CODE: 16.2 - The role of inguinal lymphadenectomy in the treatment of penile carcinoma patients
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Tomasz Kalinowski, Tomasz Demkow, Roman Sosnowski, Tomasz Chwaliński, Wojciech Rogowski

Klinika Nowotworów Układu Moczowego, Centrum Onkologii - Instytut w Warszawie

summary

Introduction. Penile carcinoma is a rare malignant neoplasm. It is known that presence of metastatic lesions in the lymph nodes negatively influences the prognosis. Beside known prognostic factors, like clinical stage of the disease (T) and tumor grade (G), others are sought to allow precise determination of further therapeutic actions.

Objectives. The study is aimed at assessing the importance of inguinal lymphedenectomy in the treatment of penile carcinoma patients.

Materials and methods. From May 1985 to September 2003 63 patients aged 21 to 78 years (median age 51 years) with histological confirmation of penile carcinoma underwent removal of inguinal lymph nodes. Stages of the disease T1, T2, T3, T4 were seen in 29, 21, 11 and 1 patient respectively. Tumor grade G1, G2, G3 were found in 6, 34 and 22 patients respectively. In 43 patients neoplastic invasion of primary tumor vessels was assessed and in 15 of them such invasion was found. Presence of metastases in removed lymph nodes was found in 39 patients, N1 - 8, N2 - 29, N3 - 3 patients. Overall survival, relation between vessel invasion and presence of nodal metastases as well as influence of N stage on survival were analyzed. Survival probability was assessed using Kaplan-Meier method. Influence of potential risk factors was assessed using D. R. Cox's model.

Results. Follow-up time ranged from 1 to 219 months. 5-year survival probability for N0 and N1-3 patients was 0.89 ?0.07 and 0.39 ?0.09 respectively. Statistically significant influence on death risk was found only for N stage (p=0.006). No statistically significant correlation was found between presence of tumor vessel invasion and N stage (p=0.755). No correlation was found between tumor grade and N stage (p=0.755) and N stage and postoperative complications (p=0.439).

Conclusions. There are no risk factors for finding metastatic lesions in lymph nodes. Survival of the patients is related to the presence of metastases in lymph nodes.