Repeat dynamic sentinel node biopsy in locally recurrent penile carcinoma

Abstract

of these patients had previously had a unilateral inguinal node dissection for groin metastases. The median disease-free interval was 18 months. The protocol and technique of primary dynamic SNB and the repeat procedure were similar, including preoperative lymphoscintigraphy and bluedye injection. Completion inguinal node dissection was only done if there was an involved sentinel node.

Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

“…40 Repeat biopsy is advised when the FNA is negative and the clinical suspicion is high. 41 A prolonged trial of antibiotics is no longer considered appropriate. Individuals with histologically positive nodes should undergo therapeutic ipsilateral radical inguinal lymph node dissection, 42 with modified dissection on the contralateral side.…”

“…Efforts to improve accuracy have led to the development of several nomograms. [41][42][43][44] Three important points should be noted: (1) these tools remained largely unvalidated in prospective studies; 41 (2) not all features can be determined for individuals undergoing penile conserving treatment; and (3) sensitivity, specificity, and false-negative rate are variable and are inferior to recent reports of high sensitivity (94%) using dynamic sentinel node biopsy. 45,46 Therefore when available, DSNB is preferred for risk stratification over nomograms.…”

Repeat Dynamic Sentinel Node Biopsy in Locally Recurrent Penile Carcinoma

“…We were interested to read the report on repeat sentinel lymph node biopsy (SLNB) by Graafland et al . [1]. Their study showed lymphatic dissemination was re‐established in the groins after previous SLNB.…”

Reply

“…We thank doctors Zhu and Ye for their interest in our article [1]. They present a recurrent penile cancer case who appeared to have direct lymphatic drainage to the pelvic lymph nodes (LNs) after previous bilateral inguinal LN dissection.…”

“…This case and our publication highlight several aspects in the management of recurrent penile cancer that we would like to bring to attention. First, every local penile tumour can be a new source of lymphatic regional spread [1,2]. Renewed nodal staging is therefore of importance.…”