Detection of lymph node metastases in penile cancer

Bloom, Jonathan; Mp, Stern; Patel, Neel; Zhang, Michael; Phillips, John L.

doi:10.21037/tau.2018.08.01

Cited by 13 publications

(6 citation statements)

References 48 publications

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“…These agents are taken up by penile lymphatics and phagocytosed by resident macrophages; these macrophages are less prevalent in metastatic nodes. In a limited study with seven men (stage T1b-T2), this detection method showed sensitivity of 100%, specificity of 97%, positive predictive value of 81.2%, and negative predictive value of 100% (15,16). This provides promise as PET/CT is only 57% accurate in predicting ILNM in patients with normal groin exams compared to 96% in patients with palpable nodes (17).…”

Section: Clinical/pathological Factorsmentioning

confidence: 99%

“…In patients who are low-risk for ILNM, an 8mm cut-off in the CT short axis provides the most accurate detection, with a sensitivity of 87% and a specificity of 81%. For patients with high risk for ILNM, size is less accurate, and the most accurate (88%) criteria for nodal involvement is an irregular nodal border with a specificity of 95% (15). Moving away from size criteria for the evaluation of ILNM in the presence of known primary SCC of the penis is crucial, as this has the tendency to miss occult metastases in normal-sized nodes and to label reactive nodes as malignant.…”

Section: Clinical/pathological Factorsmentioning

confidence: 99%

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Prognostic predictors of lymph node metastasis in penile cancer: a systematic review

et al. 2021

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Purpose: Squamous cell carcinoma (SCC) of the penis is a rare disease in developed countries but is associated with signifi cant morbidity and mortality. A crucial prognostic factor is the presence of inguinal lymph node metastases (ILNM) at the time of diagnosis. At least 25% of cases have micrometastases at the time of diagnosis. Therefore, we performed a literature review of studies evaluating factors, both clinical and pathological, predictive of lymph node metastases in penile SCC. Materials and methods: Studies were identifi ed using PubMed and search terms included the following: penile cancer, penile tumor, penile neoplasm, penile squamous cell carcinoma, inguinal lymph node metastasis, lymph node metastases, nodal metastasis, inguinal node metastasis, inguinal lymph node involvement, predictors, and predictive factor. The number of patients and predictive factors were identifi ed for each study based on OR, HR, or RR in multivariate analyses, as well as their respective signifi cance values. These were compiled to generate a single body of evidence supportive of factors predictive of ILNM in penile SCC. Results: We identifi ed 31 studies, both original articles and meta-analyses, which identifi ed factors predictive of metastases in penile SCC. The following clinical factors were predictive of ILNM in penile SCC: lymphovascular invasion (LVI), increased grade, increased stage (both clinical and pathological), infi ltrative and reticular invasion, increased depth of invasion, perineural invasion, and younger patient age at diagnosis. Biochemically, overexpression of p53, SOD2, Ki-67, and ID1 were associated with spread of SCC to inguinal lymph nodes. Diffuse PD-L1 expression, increased SCC-Ag expression, increased NLR, and CRP >20 were also associated with increased ILNM. Conclusions: A multitude of factors are associated with metastasis of SCC of the penis to inguinal lymph nodes, which is associated with poor clinical outcomes. The above factors, most strongly LVI, grade, and node positivity, may be considered when constructing a nomogram to risk-stratify patients and determine eligibility for prophylactic inguinal lymphadenectomy.

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Section: Clinical/pathological Factorsmentioning

confidence: 99%

Section: Clinical/pathological Factorsmentioning

confidence: 99%

Prognostic predictors of lymph node metastasis in penile cancer: a systematic review

et al. 2021

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“…These particles travel via penile lymphatics and undergo preferential phagocytosis by resident macrophages. Metastatic nodes often lack macrophages and accumulate less contrast, resulting in a brighter T2Ã-weighted signal [17]. A study of seven men with pT1b-pT2 pSCC found a sensitivity of 100%, specificity of 97%, a positive predictive value of 81.2% and a negative predictive value of 100% [18].…”

Section: Imagingmentioning

confidence: 99%

Recent developments in the diagnosis and management of N1 penile cancer

O’Brien

McVey

Kelly

et al. 2022

Current Opinion in Urology

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Purpose of review This article presents a critical review of the current literature to provide a brief update on the contemporary advances in diagnosing and managing N1 penile cancer. Recent findings Penile squamous cell carcinoma (pSCC) has evolved from being an orphan field for cancer innovation. Advances in the understanding tumour biology have enabled sophisticated diagnostics and predictive modelling to better characterize inguinal disease. Minimally invasive inguinal lymph node dissection is emerging as a technique that reduces morbidity while maintaining oncological safety. Furthermore, robust clinical trials are underway ,which will provide level one evidence to guide treatment decisions. Exciting advances in the field of immune-oncology offer promise as adjuvant therapies. International collaboration and centralisation of care will be essential to driving translational research and equitable evidence-based care. Summary Improving outcomes for men with pSCC remains a global challenge. Radical inguinal lymph node dissection remains the gold standard for diagnosing and curing N1 disease. Although many promising developments are on the horizon, high-level evidence is required to guide therapy.

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“…First, the cancer spreads to the sentinel lymph nodes, usually in the superficial lymph nodes near the central and superior aspects of the saphenofemoral junction, then progresses to the inferior and deep inguinal nodes, and finally to the pelvic nodes. 6 Presence of inguinal lymph node metastasis (LNM) is one of the most significant prognostic factors for patients with penile cancer. 7 The 5-year survival percentage of penile cancer patients decreases according to the regional LNMs as follows: from 90% to 100% in no involvement of lymph nodes (pN0) to 80% in unilateral lymph nodes (pN1), 40% in multiple unilateral or bilateral inguinal lymph nodes (pN2), and only 11% in patients with already involved fixed inguinal or pelvic lymph nodes (pN3).…”

Section: Introductionmentioning

confidence: 99%

Programmed Death-Ligand 1, C-reactive Protein, and Neutrophil/Lymphocyte Ratio as Lymphangiogenesis Markers of Metastasis in Penile Cancer – A Systematic Review

Yudiana,

Marta,

Sugianto

et al. 2023

Forum of Clinical Oncology

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Introduction The spread of penile cancer cells through lymphatic vessels provides the potential for using compounds involved in lymphangiogenesis, such as programmed death-ligand 1 (PD-L1), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and Ki-67, in predicting the development of lymphatic metastases in penile cancer. Methods The systematic review was conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. A literature search was conducted using the medical literature database PubMed, Scopus, ScienceDirect, EMBASE, and EBSCOHost for studies published until February 7, 2023. Results Among 527 studies identified in the literature, 21 studies met the inclusion criteria and became eligible studies. PD-L1, CRP, and NLR are biomarkers which are proven to be significantly associated with an increased risk of high-grade tumor and lymphatic metastasis in penile cancer. Conclusion PD-L1, CRP, and NLR are biomarkers that might be used to assess the risk or likelihood of developing lymphatic metastases in penile cancer.

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Detection of lymph node metastases in penile cancer

Cited by 13 publications

References 48 publications

Prognostic predictors of lymph node metastasis in penile cancer: a systematic review

Prognostic predictors of lymph node metastasis in penile cancer: a systematic review

Recent developments in the diagnosis and management of N1 penile cancer

Programmed Death-Ligand 1, C-reactive Protein, and Neutrophil/Lymphocyte Ratio as Lymphangiogenesis Markers of Metastasis in Penile Cancer – A Systematic Review

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