Presentation Authors: kai yao*, Zhi-yong Li, Xing-liang Tan, Dong Chen, Fang-jian Zhou, Guang zhou, China, People's Republic of
Introduction: This study aimed to provide an accurate map of lymph node metastasis in patients with penile cancer and to suggest the reasonable extent of pelvic lymph node dissection.
Methods: Penile cancer patients undergoing pelvic lymph node dissection (n = 128) at our institution from 1999 to 2017 were enrolled. The number of removed lymph nodes and the number of positive lymph nodes at 10 separate regions were recorded.
Results: The median number of pelvic lymph nodes retrieved was 18 (range 8-71), with the majority being from the external iliac package (43.0%) and obturator package (31.9%). Pelvic lymph node metastasis was present in 57/128 (44.5%) patients. It was not seen in the absence of inguinal lymph node metastasis. The median number of positive pelvic lymph nodes removed was 2 (range1-13), with the majority being from the external iliac package (50.0%) and obturator package (36.6%). Advanced T-stage was related with higher risk of pelvic lymph node metastasis; pelvic lymph node metastasis was present in 30.3%, 44.2%, 59.0%, and 58.3% of patients with pT1, pT2, pT3, and pT4, respectively. Notably, 3 patients had crossover metastasis from one inguinal region to the contralateral pelvic region.
Conclusions: We present a detailed map of pelvic lymph node involvement in penile carcinoma patients. The external iliac package and obturator package appear to be most commonly involved. Optimal pelvic lymph node dissection should extend to the common iliac artery.