Abstract
Objectives:To evaluate the predictive role ofprimary tumor histopathological features inpredicting inguinal lymph nodes involvement inpatients with penile squamous cell carcinoma.Material and methods:We retrospectivelyanalysed pathological records from 30consecutive patients who underwent penectomyfor invasive squamous cell carcinoma of thepenis. All histological specimens were reviewedby the same pathologist. We considered thefollowing histological parameters: histologicalgrading, growth pattern, deph invasion, tumourthickness, nuclear grading, poorlydifferentiated cancer rate, vascular andlymphatic embolization, eosinophilic andmononuclear infiltration and pathologicalstage.Results:Lymph nodes involvement occurred in 5patients who underwent `early' lymphadenectomyand in other 4 ones during oncologicalsurveillance. Lymph nodes metastasis resultedsignificantly correlated with histologicalgrading (p = 0.005), lymphatic (p = 0.005) andvenous (p = 0.02) embolization, corporacavernosa (p = 0.03) and urethra (p = 0.03)infiltration. Histological grading andlymphatic embolization were independentpredictive variables of lymph nodes involvement(p = 0.02).Conclusions:The histological grading andlymphatic embolization have to be considered asimportant parameters to select patients withpenile squamous cell carcinoma to undergo an`early' lymphadenectomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bezerra ALR, Lopes A, Santiago GH et al. Human papillomavirus as a prognostic factor in carcinoma of the penis. Cancer 91 2001; 12: 2315–2321.
Black MM, Speer FD. Nuclear structure in cancer tissues. Surg Gynecol Obstet 1957; 105: 97.
Broders AC. Squamous cell epithelioma of the skin. Ann Surg 1921; 73: 141.
Cubilla AL, Barreto J, Caballero C et al. Pathologic features of epidermoid carcinoma of the penis. Am J Surg Pathol 1993; 17: 753.
DeKernion JB, Tynberg P, Persky L, Fegen JP. Carcinoma of the penis. Cancer 1973; 32: 1256–1262.
Fleming ID, Cooper JS, Henson DE et al. Penis. In: AJCC Cancer Staging Manual 5th ed. Philadelphia: Lippincott-Raven Publishers, 1997; 33: 215–217.
Fraley E, Zhnag G, Manivel C, Niehans G. The role of ilioinguinal lymphadenectomy and significance of histological differentation in treatment of carcinoma of the penis. J Urol 1989; 142: 1478.
Gustaffsson O, Tribukait B, Nyman CR, Borgstroem E. DNA pattern and histopathology in carcinoma of the penis. A prospective study. Scan J Urol Nephrol 1988; 110 (Suppl): 219.
Hall MC, Sanders JS, Vuitch F et al. Deoxyribonucleic acid flow cytometry and traditional pathologic variables in invasive penile carcinoma: Assessment of prognostic significance. Urology 1998; 52: 111.
Hardner GJ, Bhanalaph T, Murphy GP et al. Carcinoma of the penis: Analysis of the therapy in 100 consecutive cases. J Urol 1972; 108: 428.
Horenblas S. Lymphadenectomy for squamous cell carcinoma of the penis. Part 2: The role and technique of lymph node dissection. BJU Int 2001; 88: 473–483.
Horenblas S, Van Tinteren H. Squamous cell carcinoma of the penis. Prognostic factors of survival: Analysis of tumor, nodes and metastasis classification system. J Urol 1994; 151: 1239.
Lopes A, Hidalgo GS, Kowalski LP et al. Prognostic factors in carcinoma of the penis: Multivariate analysis of 145 patients treated with amputation and lymphadenectomy. J Urol 1996; 156: 1637–1642.
McDougal WS. Carcinoma of the penis: Improved survival by early regional lymphadenectomy besed on the histological grade and depth of invasion of the primary lesion. J Urol 1995; 154: 1364.
McDougal WS, Kirchner FK, Edwards RH et al. Treatment of carcinoma of the penis in a case of primary lymphadenectomy. J Urol 1986; 136: 38.
Ornellas AA, Mendes M, Ornellas MH et al. Penile cancer: Flow cytmetry study of ploidies in 90 patients (French). Prog Urol 2000; 10: 72–77.
Schoeneich G, Perabo FGE, Muller SC. Squamous cell carcinoma of the penis. Andrologia 1999; 31 (Suppl 1): 17–20.
Slaton JW, Morgenstern N, Levy DA et al. Tumor stage, vascular invasion and the percentage of poorly differentiated cancer: Indipendent prognosticators for inguinal lymph node metastasis in penile squamous cancer. J Urol 2001; 165: 1138–1142.
Solsona E, Iborra I, Ricos JV et al. Corpus cavernosum invasio and tumor grade in the prediction of lymph node condition in penile carcinoma. Eur Urol 1992; 22: 115.
Solsona E, Iborra I, Rubio J et al. Prospective validation of local tumor stage and grade as a predictive factor for occult lymph node micrometastasis in patients with penile carcinoma and clinically negative inguinal lymph nodes. J Urol 2001; 165: 1506–1509.
Theodorescu D, Russo P, Zhang ZF et al. Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 1996; 155: 1626.
Villavicencio H, Rubio-Briones J, Regalado R et al. Grade, local stage and growth pattern as prognostic factors in carcinoma of the penis. Eur Urol 1997; 32: 442–447.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ficarra, V., Martignoni, G., Maffei, N. et al. Predictive pathological factors of lymph nodes involvement in the squamous cell carcinoma of the penis. Int Urol Nephrol 34, 245–250 (2002). https://doi.org/10.1023/A:1023243102230
Issue Date:
DOI: https://doi.org/10.1023/A:1023243102230