Skip to main content
SpringerLink
Log in

How to Manage the Lymph Nodes in Penile Cancer

  • Chapter
  • First Online:
Penile Cancer – A Practical Guide

Part of the book series: Management of Urology ((MU))

  • 121 Accesses

Abstract

The presence of metastatic disease within the inguinal lymph nodes represents the most important prognostic indicator for men with penile cancer. In penile cancer metastatic spread typically follows a stepwise and predictable pattern, from the penis to the inguinal lymph nodes, unilaterally or bilaterally, followed by drainage to the ipsilateral pelvic lymph nodes and finally developing systemic spread. Radical inguinal lymph node dissection has previously been the standard management for inguinal lymph nodes in men with high-risk penile cancer despite the high rates of peri-operative and long terms complications. However, a contemporary risk-adapted approach, especially in cN0 cases, including the use of dynamic sentinel node biopsy, modified and superficial lymph node dissection and the videoendoscopic approach, are aimed at decreasing complication rates while increasing quality of life for penile cancer survivors. In addition, the use of neo-adjuvant and adjuvant chemotherapy, radiotherapy and more recently immunotherapy in advanced nodal disease can also increase survival rates where there is significant lymph node involvement.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ornellas AA. Management of penile cancer. J Surg Oncol. 2008;97(3):199–200.

    Article  PubMed  Google Scholar 

  2. Chipollini J, Necchi A, Spiess PE. Outcomes for patients with node-positive penile cancer: impact of perioperative systemic therapies and the importance of surgical intervention. Eur Urol. 2018;74(2):241–2.

    Article  PubMed  Google Scholar 

  3. Thomas A, Necchi A, Muneer A, Tobias-Machado M, Tran ATH, Rompuy A-SV, et al. Penile cancer. Nat Rev Dis Primers. 2021;7(1):11.

    Article  PubMed  Google Scholar 

  4. Villavicencio H, Rubio-Briones J, Regalado R, Chéchile G, Algaba F, Palou J. Grade, local stage and growth pattern as prognostic factors in carcinoma of the penis. Eur Urol. 1997;32(4):442–7.

    Article  CAS  PubMed  Google Scholar 

  5. Lopes A, Hidalgo GS, Kowalski LP, Torloni H, Rossi BM, Fonseca FP. Prognostic factors in carcinoma of the penis: multivariate analysis of 145 patients treated with amputation and lymphadenectomy. J Urol. 1996;156(5):1637–42.

    Article  CAS  PubMed  Google Scholar 

  6. Ficarra V, Akduman B, Bouchot O, Palou J, Tobias-Machado M. Prognostic factors in penile cancer. Urology. 2010;76(2):S66–73.

    Article  PubMed  Google Scholar 

  7. Djajadiningrat RS, Graafland NM, van Werkhoven E, Meinhardt W, Bex A, van der Poel HG, et al. Contemporary management of regional nodes in penile cancer—improvement of survival? J Urol. 2014;191(1):68–73.

    Article  PubMed  Google Scholar 

  8. Srinivas V, Morse MJ, Herr HW, Sogani PC, Whitmore WF. Penile cancer: relation of extent of nodal metastasis to survival. J Urol. 1987;137(5):880–1.

    Article  CAS  PubMed  Google Scholar 

  9. Hughes BE, Leijte JAP, Kroon BK, Shabbir MA, Swallow TW, Heenan SD, et al. Lymph node metastasis in intermediate-risk penile squamous cell cancer: a two-Centre experience. Eur Urol. 2010;57(4):688–92.

    Article  PubMed  Google Scholar 

  10. Graafland NM, Lam W, Leijte JAP, Yap T, Gallee MPW, Corbishley C, et al. Prognostic factors for occult inguinal lymph node involvement in penile carcinoma and assessment of the high-risk EAU subgroup: a two-institution analysis of 342 clinically node-negative patients. Eur Urol. 2010;58(5):742–7.

    Article  PubMed  Google Scholar 

  11. Misra S, Chaturvedi A, Misra NC. Penile carcinoma: a challenge for the developing world. Lancet Oncol. 2004;5(4):240–7.

    Article  PubMed  Google Scholar 

  12. Zekan DS, Dahman A, Hajiran AJ, Luchey AM, Chahoud J, Spiess PE. Prognostic predictors of lymph node metastasis in penile cancer: a systematic review. Int Braz J Urol. 2021;47(5):943–56.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Theodorescu D, Russo P, Zhang ZF, Morash C, Fair WR. Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol. 1996;155(5):1626–31.

    Article  CAS  PubMed  Google Scholar 

  14. Velazquez EF, Ayala G, Liu H, Chaux A, Zanotti M, Torres J, et al. Histologic grade and perineural invasion are more important than tumor thickness as predictor of nodal metastasis in penile squamous cell carcinoma invading 5 to 10 mm. Am J Surg Pathol. 2008;32(7):974–9.

    Article  PubMed  Google Scholar 

  15. Alkatout I, Naumann CM, Hedderich J, Hegele A, Bolenz C, Jünemann K-P, et al. Squamous cell carcinoma of the penis: predicting nodal metastases by histologic grade, pattern of invasion and clinical examination. Urol Oncol. 2011;29(6):774–81.

    Article  PubMed  Google Scholar 

  16. Ficarra V, Maffei N, Piacentini I, Rabi NA, Cerruto MA, Artibani W. Local treatment of penile squamous cell carcinoma. Urol Int. 2002;69(3):169–73.

    Article  PubMed  Google Scholar 

  17. Zhou X, Qi F, Zhou R, Wang S, Wang Y, Wang Y, et al. The role of perineural invasion in penile cancer: a meta-analysis and systematic review. Biosci Rep. 2018;38(5):BSR20180333.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Emerson RE, Ulbright TM, Eble JN, Geary WA, Eckert GJ, Cheng L. Predicting cancer progression in patients with penile squamous cell carcinoma: the importance of depth of invasion and vascular invasion. Modern Pathol. 2001;14(10):963–8.

    Article  CAS  Google Scholar 

  19. Dai B, Ye DW, Kong YY, Yao XD, Zhang HL, Shen YJ. Predicting regional lymph node metastasis in Chinese patients with penile squamous cell carcinoma: the role of histopathological classification, tumor stage and depth of invasion. J Urol. 2006;176(4):1431–5.

    Article  PubMed  Google Scholar 

  20. Zhu Y, Zhou XY, Yao XD, Dai B, Ye DW. The prognostic significance of p53, Ki-67, epithelial cadherin and matrix metalloproteinase-9 in penile squamous cell carcinoma treated with surgery. BJU Int. 2007;100(1):204–8.

    Article  CAS  PubMed  Google Scholar 

  21. Pizzocaro G, Piva L, Bandieramonte G, Tanac S. Up-to-date management of carcinoma of the penis. Eur Urol. 1997;32(1):5–15.

    Article  CAS  PubMed  Google Scholar 

  22. Qu XM, Siemens DR, Louie AV, Yip D, Mahmud A. Validation of predictors for lymph node status in penile cancer: results from a population-based cohort. Can Urol Assoc J. 2017;12(4):119–25.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lopes A, Bezerra ALR, Pinto CAL, Serrano SV, de Mello CA, Villa LL. p53 as a new prognostic factor for lymph node metastasis in penile carcinoma: analysis of 82 patients treated with amputation and bilateral lymphadenectomy. J Urol. 2002;168(1):81–6.

    Article  PubMed  Google Scholar 

  24. Hu J, Cui Y, Liu P, Zhou X, Ren W, Chen J, et al. Predictors of inguinal lymph node metastasis in penile cancer patients: a meta-analysis of retrospective studies. Cancer Manag Res. 2019;11:6425–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Li K, Sun J, Wei X, Wu G, Wang F, Fan C, et al. Prognostic value of lymphovascular invasion in patients with squamous cell carcinoma of the penis following surgery. BMC Cancer. 2019;19(1):476.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Termini L, Fregnani JH, Boccardo E, da Costa WH, Longatto-Filho A, Andreoli MA, et al. SOD2 immunoexpression predicts lymph node metastasis in penile cancer. Bmc Clin Pathol. 2015;15(1):3.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Maciel CVDM, Machado RD, Morini MA, Mattos PAL, dos Reis R, dos Reis RB, et al. External validation of nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes. Int Braz J Urol. 2019;45(4):671–8.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ramkumar A, Seshadri RA, Narayanaswamy K, Balasubramanian S. Risk factors for lymph node metastasis in clinically node-negative penile cancer patients. Int J Urol. 2009;16(4):383–6.

    Article  PubMed  Google Scholar 

  29. Warli SM, Siregar GP. Over-expression of Ki-67 as a predictor of lymph node metastasis in penile cancer patients. F1000research. 2020;9:289.

    Article  CAS  Google Scholar 

  30. Ghazal AA, Steffens S, Steinestel J, Lehmann R, Schnoeller TJ, Schulte-Hostede A, et al. Elevated C-reactive protein values predict nodal metastasis in patients with penile cancer. BMC Urol. 2013;13(1):53.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hu X, Chen M, Li Y, Wang Y, Wen S, Jun F. Overexpression of ID1 promotes tumor progression in penile squamous cell carcinoma. Oncol Rep. 2019;41(2):1091–100.

    CAS  PubMed  Google Scholar 

  32. Unadkat P, Fleishman A, Olumi AF, Wagner A, Chang P, Kim SP, et al. Contemporary incidence and predictors of occult inguinal lymph node metastases in men with clinically node-negative (cN0) penile cancer. Urology. 2021;153:221–7.

    Article  PubMed  Google Scholar 

  33. Su X, Zhang J, Fu C, Xiao M, Wang C. Recurrent metastatic penile cancer patient with positive PD-L1 expression obtained significant benefit from immunotherapy: a case report and literature review. Oncotargets Ther. 2020;13:3319–24.

    Article  Google Scholar 

  34. Azizi M, Peyton CC, Boulware DC, Chipollini J, Juwono T, Pow-Sang JM, et al. Prognostic value of neutrophil-to-lymphocyte ratio in penile squamous cell carcinoma patients undergoing inguinal lymph node dissection. Eur Urol Focus. 2019;5(6):1085–90.

    Article  PubMed  Google Scholar 

  35. Kroon BK, Horenblas S, Lont A, Tanis PJ, Gallee MPW, Nieweg OE. Patients with penile carcinoma benefit from immediate resection of clinically occult lymph node metastases. J Urol. 2005;173(3):816–9.

    Article  CAS  PubMed  Google Scholar 

  36. Pagliaro LC, Crook J. Multimodality therapy in penile cancer: when and which treatments? World J Urol. 2009;27(2):221–5.

    Article  CAS  PubMed  Google Scholar 

  37. Spiess PE, Izawa JI, Bassett R, Kedar D, Busby JE, Wong F, et al. Preoperative lymphoscintigraphy and dynamic sentinel node biopsy for staging penile cancer: results with pathological correlation. J Urol. 2007;177(6):2157–61.

    Article  PubMed  Google Scholar 

  38. Ross G, Shoaib T, Scott J, Soutar DS, Gray H, Mackie R. The learning curve for sentinel node biopsy in malignant melanoma. Br J Plast Surg. 2002;55(4):298–301.

    Article  CAS  PubMed  Google Scholar 

  39. Woldu SL, Ci B, Hutchinson RC, Krabbe L-M, Singla N, Passoni NM, et al. Usage and survival implications of surgical staging of inguinal lymph nodes in intermediate- to high-risk, clinical localized penile cancer: a propensity-score matched analysis. Urol Oncol. 2018;36(4):159.e7–159.e17.

    Article  PubMed  Google Scholar 

  40. Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, et al., editors. AJCC cancer staging manual [Internet]. Vol. XVII. Springer International Publishing; 2017 [cited 2017]. 1032 p. Available from: https://link.springer.com/gp/book/9783319406176

  41. Leone A, Diorio GJ, Pettaway C, Master V, Spiess PE. Contemporary management of patients with penile cancer and lymph node metastasis. Nat Rev Urol. 2017;14(6):335–47.

    Article  PubMed  Google Scholar 

  42. Derakhshani P, Neubauer S, Braun M, Bargmann H, Heidenreich A, Engelmann U. Results and 10-year follow-up in patients with squamous cell carcinoma of the penis. Urol Int. 1999;62(4):238–44.

    Article  CAS  PubMed  Google Scholar 

  43. Heyns CF, Fleshner N, Sangar V, Schlenker B, Yuvaraja TB, van Poppel H. Management of the lymph nodes in penile cancer. Urology. 2010;76(2):S43–57.

    Article  PubMed  Google Scholar 

  44. Hakenberg OW, Compérat E, Minhas S, Necchi A, Protzel C, Watkin N, et al. EAU Guidelines on Penile Cancer 2020. In: Office EG, editor. 2020 [cited 2022 Feb 5]. Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-on-Penile-Cancer-2020.pdf

  45. (NCCN) NCCN, editor. NCCN Clinical Practice Guidelines in Oncology. Penile Cancer. Version 2.2022. In 2022 [cited 2022 Feb 5]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/penile.pdf

  46. Ornellas AA, Nóbrega BLB, Chin EWK, Wisnescky A, da Silva PCB, Schwindt ABDS. Prognostic factors in invasive squamous cell carcinoma of the penis: analysis of 196 patients treated at the Brazilian National Cancer Institute. J Urol. 2008;180(4):1354–9.

    Article  PubMed  Google Scholar 

  47. Kirrander P, Sherif A, Friedrich B, Lambe M, Håkansson U, Register SC of the SNPC. Swedish National Penile Cancer Register: incidence, tumour characteristics, management and survival. BJU Int. 2016;117(2):287–92.

    Article  PubMed  Google Scholar 

  48. Graafland NM, Teertstra HJ, Besnard APE, van Boven HH, Horenblas S. Identification of high risk pathological node positive penile carcinoma: value of preoperative computerized tomography imaging. J Urol. 2011;185(3):881–7.

    Article  PubMed  Google Scholar 

  49. Mueller-Lisse UG, Scher B, Scherr MK, Seitz M. Functional imaging in penile cancer & colon; PET/computed tomography, MRI, and sentinel lymph node biopsy. Curr Opin Urol. 2008;18(1):105–10.

    Article  PubMed  Google Scholar 

  50. Hedgire SS, Pargaonkar VK, Elmi A, Harisinghani AM, Harisinghani MG. Pelvic nodal imaging. Radiol Clin N Am. 2012;50(6):1111–25.

    Article  PubMed  Google Scholar 

  51. Caso JR, Rodriguez AR, Correa J, Spies PE. Update in the management of penile cancer. Int Braz J Urol. 2009;35(4):406–15.

    Article  PubMed  Google Scholar 

  52. Salazar A, Júnior EP, Salles PGO, Silva-Filho R, Reis EA, Mamede M. 18F-FDG PET/CT as a prognostic factor in penile cancer. Eur J Nucl Med Mol I. 2019;46(4):855–63.

    Article  CAS  Google Scholar 

  53. Scher B, Seitz M, Albinger W, Reiser M, Schlenker B, Stief C, et al. PET in oncology. Recent Results Canc. 2008:159–79.

    Google Scholar 

  54. Bloom JB, Stern M, Patel NH, Zhang M, Phillips JL. Detection of lymph node metastases in penile cancer. Transl Androl Urol. 2018;7(5):879–86.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Sadeghi R, Gholami H, Zakavi SR, Kakhki VRD, Horenblas S. Accuracy of 18F-FDG PET/CT for diagnosing inguinal lymph node involvement in penile squamous cell carcinoma. Clin Nucl Med. 2012;37(5):436–41.

    Article  PubMed  Google Scholar 

  56. Ottenhof SR, Vegt E. The role of PET/CT imaging in penile cancer. Transl Androl Urol. 2017;6(5):833–8.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Cabanas RM. An approach for the treatment of penile carcinoma. Cancer. 1977;39(2):456–66.

    Article  CAS  PubMed  Google Scholar 

  58. Lam W, Alnajjar HM, La-Touche S, Perry M, Sharma D, Corbishley C, et al. Dynamic sentinel lymph node biopsy in patients with invasive squamous cell carcinoma of the penis: a prospective study of the long-term outcome of 500 inguinal basins assessed at a single institution. Eur Urol. 2013;63(4):657–63.

    Article  PubMed  Google Scholar 

  59. Horenblas S, Kroger R, Gallee MPW, Newling DWW, Tinteren HV. Ultrasound in squamous cell carcinoma of the penis; a useful addition to clinical staging? A comparison of ultrasound with histopathology. Urology. 1994;43(5):702–7.

    Article  CAS  PubMed  Google Scholar 

  60. Leijte JAP, Olmos RAV, Nieweg OE, Horenblas S. Anatomical mapping of lymphatic drainage in penile carcinoma with SPECT-CT: implications for the extent of inguinal lymph node dissection. Eur Urol. 2008;54(4):885–92.

    Article  PubMed  Google Scholar 

  61. Lützen U, Naumann CM, Marx M, Zhao Y, Jüptner M, Baumann R, et al. A study on the value of computer-assisted assessment for SPECT/CT-scans in sentinel lymph node diagnostics of penile cancer as well as clinical reliability and morbidity of this procedure. Cancer Imaging. 2016;16(1):29.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Sadeghi R, Gholami H, Zakavi SR, Kakhki VRD, Tabasi KT, Horenblas S. Accuracy of sentinel lymph node biopsy for inguinal lymph node staging of penile squamous cell carcinoma: systematic review and meta-analysis of the literature. J Urol. 2012;187(1):25–31.

    Article  PubMed  Google Scholar 

  63. Dell’Oglio P, de Vries HM, Mazzone E, KleinJan GH, Donswijk ML, van der Poel HG, et al. Hybrid indocyanine green–99mTc-nanocolloid for single-photon emission computed tomography and combined radio- and fluorescence-guided sentinel node biopsy in penile cancer: results of 740 inguinal basins assessed at a single institution. Eur Urol. 2020;78(6):865–72.

    Article  PubMed  Google Scholar 

  64. Brouwer OR, Buckle T, Vermeeren L, Klop WMC, Balm AJM, van der Poel HG, et al. Comparing the hybrid fluorescent–radioactive tracer indocyanine green–99mTc-Nanocolloid with 99mTc-Nanocolloid for sentinel node identification: a validation study using lymphoscintigraphy and SPECT/CT. J Nucl Med. 2012;53(7):1034–40.

    Article  CAS  PubMed  Google Scholar 

  65. Leijte JAP, Kroon BK, Olmos RAV, Nieweg OE, Horenblas S. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol. 2007;52(1):170–7.

    Article  PubMed  Google Scholar 

  66. Leijte JAP, van der Ploeg IMC, Olmos RAV, Nieweg OE, Horenblas S. Visualization of tumor blockage and rerouting of lymphatic drainage in penile cancer patients by use of SPECT/CT. J Nucl Med. 2009;50(3):364–7.

    Article  PubMed  Google Scholar 

  67. Kroon BK, Horenblas S, Estourgie SH, Lont AP, Rav O, Nieweg OE. How to avoid false-negative dynamic sentinel node procedures in penile carcinoma. J Urol. 2004;171(6):2191–4.

    Article  CAS  PubMed  Google Scholar 

  68. Kroon BK, Horenblas S, Deurloo EE, Nieweg OE, Teertstra HJ. Ultrasonography-guided fine-needle aspiration cytology before sentinel node biopsy in patients with penile carcinoma. BJU Int. 2005;95(4):517–21.

    Article  PubMed  Google Scholar 

  69. Jakobsen JK, Alslev L, Ipsen P, Costa JC, Krarup KP, Sommer P, et al. DaPeCa-3: promising results of sentinel node biopsy combined with 18F-fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node-negative patients with penile cancer—a national study from Denmark. BJU Int. 2016;118(1):102–11.

    Article  PubMed  Google Scholar 

  70. Hadway P, Smith Y, Corbishley C, Heenan S, Watkin NA. Evaluation of dynamic lymphoscintigraphy and sentinel lymph-node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma. BJU Int. 2007;100(3):561–5.

    Article  PubMed  Google Scholar 

  71. Crawshaw JW, Hadway P, Hoffland D, Bassingham S, Corbishley CM, Smith Y, et al. Sentinel lymph node biopsy using dynamic lymphoscintigraphy combined with ultrasound-guided fine needle aspiration in penile carcinoma. Br J Radiol. 2009;82(973):41–8.

    Article  CAS  PubMed  Google Scholar 

  72. Sahdev V, Albersen M, Christodoulidou M, Parnham A, Malone P, Nigam R, et al. Management of non-visualization following dynamic sentinel lymph node biopsy for squamous cell carcinoma of the penis. BJU Int. 2017;119(4):573–8.

    Article  PubMed  Google Scholar 

  73. Graafland NM, Leijte JAP, Olmos RAV, Boven HHV, Nieweg OE, Horenblas S. Repeat dynamic sentinel node biopsy in locally recurrent penile carcinoma. BJU Int. 2010;105(8):1121–4.

    Article  PubMed  Google Scholar 

  74. Kroon BK, Lont AP, Rav O, Nieweg OE, Horenblas S, Morbidity of dynamic sentinel node biopsy in penile carcinoma. J Urol. 2005;173(3):813–5.

    Article  CAS  PubMed  Google Scholar 

  75. Leijte JAP, Hughes B, Graafland NM, Kroon BK, Olmos RAV, Nieweg OE, et al. Two-center evaluation of dynamic sentinel node biopsy for squamous cell carcinoma of the penis. J Clin Oncol. 2009;27(20):3325–9.

    Article  PubMed  Google Scholar 

  76. Nabavizadeh R, Petrinec B, Nabavizadeh B, Singh A, Rawal S, Master V. Inguinal lymph node dissection in the era of minimally invasive surgical technology. Urol Oncol Seminars Orig Investigations. 2020;

    Google Scholar 

  77. Soodana-Prakash N, Koru-Sengul T, Miao F, Lopategui DM, Savio LF, Moore KJ, et al. Lymph node yield as a predictor of overall survival following inguinal lymphadenectomy for penile cancer. Urol Oncol. 2018;36(10):471.e19–27.

    Article  PubMed  Google Scholar 

  78. Gupta MK, Patel AP, Master VA. Technical considerations to minimize complications of inguinal lymph node dissection. Transl Androl Urol. 2017;6(5):820–5.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Chipollini J, Garcia-Castaneda J, la Rosa AH-D, Cheriyan S, Azizi M, Spiess PE. Important surgical concepts and techniques in inguinal lymph node dissection. Curr Opin Urol. 2019;29(3):286–92.

    Article  PubMed  Google Scholar 

  80. Coba G, Patel T. Penile cancer: managing sexual dysfunction and improving quality of life after therapy. Curr Urol Rep. 2021;22(2):8.

    Article  PubMed  Google Scholar 

  81. Catalona WJ. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J Urol. 1988;140(2):306–10.

    Article  CAS  PubMed  Google Scholar 

  82. Selçuk İ, Akdemir HA, Ersak B, Tatar İ, Sargon MF, Güngör T. Inguinofemoral lymphadenectomy and femoral dissection: cadaveric educational video. J Turkish Ger Gynecol Assoc. 2021;22(2):155–7.

    Article  Google Scholar 

  83. Niyogi D, Noronha J, Pal M, Bakshi G, Prakash G. Management of clinically node-negative groin in patients with penile cancer. Indian J Urol Iju J Urol Soc India. 2020;36(1):8–15.

    Article  Google Scholar 

  84. Hora M, Trávníček I, Nykodýmová Š, Ferda J, Kacerovská D, Michalová K, et al. VEILND (video endoscopic inguinal lymph node dissection) with florescence indocyanine green (ICG): a novel technique to identify the sentinel lymph node in men with ≥pT1G2 and cN0 penile cancer. Contrast Media Mol I. 2021;2021:5575730.

    Article  Google Scholar 

  85. Tobias-Machado M, Tavares A, Ornellas AA, Molina WR, Juliano RV, Wroclawski ER. Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma. J Urol. 2007;177(3):953–8.

    Article  PubMed  Google Scholar 

  86. Hu J, Li H, Cui Y, Liu P, Zhou X, Liu L, et al. Comparison of clinical feasibility and oncological outcomes between video endoscopic and open inguinal lymphadenectomy for penile cancer. Medicine. 2019;98(22):e15862.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Elsamra SE, Poch MA. Robotic inguinal lymphadenectomy for penile cancer: the why, how, and what. Transl Androl Urol. 2017;6(5):826–32.

    Article  PubMed  PubMed Central  Google Scholar 

  88. O’Brien JS, Perera M, Manning T, Bozin M, Cabarkapa S, Chen E, et al. Penile cancer: contemporary lymph node management. J Urol. 2017;197(6):1387–95.

    Article  PubMed  Google Scholar 

  89. Graafland NM, Moonen LMF, van Boven HH, van Werkhoven E, Kerst JM, Horenblas S. Inguinal recurrence following therapeutic lymphadenectomy for node positive penile carcinoma: outcome and implications for management. J Urol. 2011;185(3):888–94.

    Article  PubMed  Google Scholar 

  90. Winters BR, Kearns JT, Holt SK, Mossanen M, Lin DW, Wright JL. Is there a benefit to adjuvant radiation in stage III penile cancer after lymph node dissection? Findings from the National Cancer Database. Urol Oncol. 2018;36(3):92.e11–6.

    Article  PubMed  Google Scholar 

  91. Franks KN, Kancherla K, Sethugavalar B, Whelan P, Eardley I, Kiltie AE. Radiotherapy for node positive penile cancer: experience of the leeds teaching hospitals. J Urol. 2011;186(2):524–9.

    Article  PubMed  Google Scholar 

  92. Robinson R, Marconi L, MacPepple E, Hakenberg OW, Watkin N, Yuan Y, et al. Risks and benefits of adjuvant radiotherapy after inguinal lymphadenectomy in node-positive penile cancer: a systematic review by the European Association of Urology Penile Cancer Guidelines Panel. Eur Urol. 2018;74(1):76–83.

    Article  PubMed  Google Scholar 

  93. Lorenzo GD, Buonerba C, Federico P, Perdonà S, Aieta M, Rescigno P, et al. Cisplatin and 5-fluorouracil in inoperable, stage IV squamous cell carcinoma of the penis. BJU Int. 2012;110(11b):E661–6.

    Article  PubMed  Google Scholar 

  94. Eliason M, Bowen G, Bowen A, Hazard L, Samlowski W. Primary treatment of verrucous carcinoma of the penis with fluorouracil, cis-diamino-dichloro-platinum, and radiation therapy. Arch Dermatol. 2009;145(8):950–2.

    Article  PubMed  Google Scholar 

  95. Necchi A, Pond GR, Raggi D, Ottenhof SR, Djajadiningrat RS, Horenblas S, et al. Clinical outcomes of perioperative chemotherapy in patients with locally advanced penile squamous-cell carcinoma: results of a multicenter analysis. Clin Genitourin Canc. 2017;15(5):548–55.e3

    Article  Google Scholar 

  96. Bandini M, Pederzoli F, Necchi A. Neoadjuvant chemotherapy for lymph node-positive penile cancer: current evidence and knowledge. Curr Opin Urol. 2020;30(2):218–22.

    Article  PubMed  Google Scholar 

  97. Lorenzo GD, Federico P, Buonerba C, Longo N, Cartenì G, Autorino R, et al. Paclitaxel in pretreated metastatic penile cancer: final results of a phase 2 study. Eur Urol. 2011;60(6):1280–4.

    Article  PubMed  Google Scholar 

  98. Power DG, Galvin DJ, Cuffe S, McVey GP, Mulholland PJ, Farrelly C, et al. Cisplatin and gemcitabine in the management of metastatic penile cancer. Urol Oncol. 2009;27(2):187–90.

    Article  CAS  PubMed  Google Scholar 

  99. Necchi A, Vullo SL, Mariani L, Zhu Y, Ye D-W, Ornellas AA, et al. Nomogram-based prediction of overall survival after regional lymph node dissection and the role of perioperative chemotherapy in penile squamous cell carcinoma: a retrospective multicenter study. Urol Oncol. 2019;37(8):531.e7–531.e15.

    Article  PubMed  Google Scholar 

  100. Noronha V, Patil V, Ostwal V, Tongaonkar H, Bakshi G, Prabhash K. Role of paclitaxel and platinum-based adjuvant chemotherapy in high-risk penile cancer. Urol Ann. 2012;4(3):150–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

    Giuseppe Fallara & Andrea Salonia

  2. University Vita-Salute San Raffaele, Milan, Italy

    Giuseppe Fallara & Andrea Salonia

  3. Department of Urology, University College London Hospitals, London, UK

    Giuseppe Fallara & Asif Muneer

  4. National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals, London, UK

    Asif Muneer

  5. Division of Surgery and Interventional Science, University College London, London, UK

    Asif Muneer

  6. Male Genital Cancer Centre, University College London, London, UK

    Asif Muneer

Authors
  1. Giuseppe Fallara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrea Salonia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Asif Muneer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Asif Muneer .

Editor information

Editors and Affiliations

  1. King’s College London, London, UK

    Oliver Brunckhorst

  2. King’s College London, London, UK

    Kamran Ahmed

  3. University College London Hospital and University College London, London, UK

    Asif Muneer

  4. University College London Hospital and University College London, London, UK

    Hussain M Alnajjar

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fallara, G., Salonia, A., Muneer, A. (2023). How to Manage the Lymph Nodes in Penile Cancer. In: Brunckhorst, O., Ahmed, K., Muneer, A., Alnajjar, H.M. (eds) Penile Cancer – A Practical Guide. Management of Urology. Springer, Cham. https://doi.org/10.1007/978-3-031-32681-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32681-3_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32680-6

  • Online ISBN: 978-3-031-32681-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation