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Morbidity and risk factors for complications of inguinal lymph node dissection in penile cancer

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Abstract

Purpose

To assess the morbidity of inguinal lymph node dissection (ILND) in penile cancer, then to compare this morbidity with that of ILND performed in the context of skin cancer treatment.

Methods

We retrospectively included all patients having undergone ILND between 1 January 2004 and 31 December 2019 in our centre’s urology department in the context of treatment of penile cancer or skin cancer. Postoperative complications were reported in accordance with the Clavien–Dindo classification system.

Results

Two hundred forty-two ILNDs were performed in 122 patients with penile cancer and 56 ILNDs were performed in 56 patients with skin cancer. The most common early complication was postoperative fluid collection (lymphocele or haematoma), which complicated 44% of ILNDs overall and 60% of radical lymphadenectomies. The most common late complication was leg lymphoedema, found in up to 36% of radical lymphadenectomies. Major complications (grade ≥ III) were very rare (4% of radical lymphadenectomies). Radical lymphadenectomies resulted in significantly more cases of postoperative fluid collection, skin necrosis and dehiscence, as well as leg lymphoedema, than modified lymphadenectomy techniques. Two factors significantly increasing postoperative morbidity were demonstrated: ASA score = 3 (OR = 3.09) and operating time (OR = 1.01).

Conclusion

ILNDs are morbid surgical procedures for which the indications must be well defined. However, the complications are almost exclusively minor, for a major oncological benefit.

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Data are available from the corresponding author on request.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 place Alexis Ricordeau, 44093, Nantes, France

    Antoine Jeanne-Julien, Olivier Bouchot, Stéphane De Vergie, Julien Branchereau, Marie-Aimée Perrouin-Verbe & Jérôme Rigaud

Authors
  1. Antoine Jeanne-Julien
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  2. Olivier Bouchot
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  3. Stéphane De Vergie
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  4. Julien Branchereau
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  5. Marie-Aimée Perrouin-Verbe
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  6. Jérôme Rigaud
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Contributions

AJ-J: project development, data collection, data analysis, and manuscript writing. OB: data collection. SDV: data collection. JB: data collection. MAP-V: data collection. JR: project development, data collection, data analysis, and manuscript writing.

Corresponding author

Correspondence to Antoine Jeanne-Julien.

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The authors have no competing interests to declare that are relevant to the content of this article.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Local Ethics Committee (Groupe Nantais d’Ethique dans le Domaine de la Santé, 2021).

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For this type of study, an approval or informed consent is not required (retrospective study). Analysed data were completely anonymized.

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Jeanne-Julien, A., Bouchot, O., De Vergie, S. et al. Morbidity and risk factors for complications of inguinal lymph node dissection in penile cancer. World J Urol 41, 109–118 (2023). https://doi.org/10.1007/s00345-022-04169-y

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