PURPOSE: The purpose of this study is to assess the merit of performing a salvage inguinal lymph node dissection (ILND) in those infrequent penile cancer patients with locally recurrent inguinal lymph node metastases in the absence of other suspected sites of disease.
MATERIALS AND METHODS: 20 patients were retrospectively identified to have undergone salvage ILND for locally recurrent penile cancer. Patients were previously treated by primary ILND with curative intent. At the time of salvage ILND, superficial and deep ILND were performed with resection outside of the standardized surgical template if an inguinal recurrence occurred outside of this region.
RESULTS: All cases were primary penile squamous cell carcinomas. The median time to recurrence from date of initial ILND was 7.7 months (3.1-35.0). At the time of salvage ILND, a median of 3 (1-17) lymph nodes was resected, with a median of 2 (1-7) nodes positive for malignancy. Median overall survival following salvage ILND was 10.1 months (95% CI: 1.9-18.3) and median disease-specific survival following salvage ILND was 16.4 months (95% CI: 5.1-27.8) Of the initial 20 patients, 9 have no evidence of disease (median follow-up 12.0 months (7.1-70.1)); 11 patients developed post-operative complications with wound infections in 6, postoperative severe (debilitating) lymphedema in 4, and seroma in 1.
CONCLUSIONS: Salvage ILND is a potentially curative treatment in penile cancer patients with locally recurrent inguinal lymph node metastases in the absence of occult disease. Patients undergoing such salvage surgery should be informed of the high likelihood of postoperative complications.
Written by:
Baumgarten AS, Alhammali E, Hakky TS, Espiritu PN, Pow-Sang JM, Sexton WJ, Lockhart JL, Protzel C, Muneer A, Spiess PE. Are you the author?
Moffitt Cancer Center, Department of Genitourinary Oncology, Tampa, FL; University of Rostock, Department of Urology, Rostock, Germany; University College London Hospital, Department of Urology, London, UK.
Reference: J Urol. 2014 Mar 3. pii: S0022-5347(14)02822-5.
doi: 10.1016/j.juro.2014.02.2563
PubMed Abstract
PMID: 24603104
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