To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL).
Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range.
From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively.
VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.
International braz j urol : official journal of the Brazilian Society of Urology. 2023 Jun 20 [Epub ahead of print]
Marcos Tobias-Machado, Antonio A Ornellas, Alexandre K Hidaka, Luis G Medina, Pablo A L Mattos, Ruben S Besio, Diego Abreu, Pedro R Castro, Ricardo H Nishimoto, Juan Astigueta, Aurus Dourado, Roberto D Machado, Wesley J Magnabosco, Victor Corona-Montes, Gustavo M Villoldo, Hamilton C Zampolli, Anis Taha, Pericles R Auad, Eliney F Faria, Paulo B O Arantes, Alessandro Tavares, Francisco S M S Nascimento, Eder S Brazão, Maurício M Rocha, Walter H Costa, Vinicius Panico, Leonardo O Reis, Roberto J Almeida-Carrera, Rafael C Silva, Stênio C Zequi, José R R Calixto, Rene Sotelo
Instituto do Cancer Arnaldo Vieira de Carvalho, São Paulo, SP, Brasil., Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil., Centro Universitário Faculdade de Medicina do ABC - FMABC, Santo André, SP, Brasil., USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Associação Piauiense de Combate ao Câncer - Hospital São Marcos, Teresina, PI, Brasil., Hospital Pasteur, Montevideo, Uruguay., Hospital Felício Rocho, Belo Horizonte, MG, Brasil., Hospital Madre Teresa, Belo Horizonte, MG, Brasil., Universidad Privada Antenor Orrego, Instituto Regional de Enfermedades Neoplásicas Norte, Trujillo, Perú., Hospital de Amor, Barretos, Barretos, SP, Brasil., Hospital Câncer de Barretos, Barretos, SP, Brasil., Hospital General de México "Dr. Eduardo Liceaga", Mexico city, México., Alexander Fleming Institute, Buenos Aires, Argentina., Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brasil., Universidade Federal do Maranhão - UFMA, Maranhão, MA, Brasil., AC Camargo Cancer Center, São Paulo, SP, Brasil., National Institute for Science and Technology in Ocogenomic and Therapeutic Innovation INCIT/INOTE AC Camargo Cancer Center, São Paulo, SP, Brasil., UroScience, Escola de Ciências Médicas, Universidade de Campinas - UNICAMP, Campinas, SP, Brasil., Hospital Carlos Andrade Marin, Quito, Equador.