The isolated gamma probe technique for sentinel node penile carcinoma detection is unreliable

Gonzaga-Silva, Lúcio Flávio; Tavares, José Marconi; Freitas, Fernando C.; Filho, Manoel E. Tomas; Oliveira, Vladmir P.; Lima, Marcos Venício Alves

doi:10.1590/s1677-55382007000100009

Cited by 33 publications

(12 citation statements)

References 14 publications

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“…For example, Gonzaga-Silva et al, using gamma probe in the sentinel lymph node, showed sensitivity of only 25% and 42.8% of false negative results (7).…”

Section: Introductionmentioning

confidence: 99%

Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

Fonseca¹,

Soares²,

Burbano³

et al. 2013

Int. braz j urol.

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Objectives: To evaluate the prevalence, distribution and association of HPV with histological pattern of worse prognosis of penile cancer, in order to evaluate its predictive value of inguinal metastasis, as well as evaluation of other previous reported prognostic factors. Material and Methods: Tumor samples of 82 patients with penile carcinoma were tested in order to establish the prevalence and distribution of genotypic HPV using PCR. HPV status was correlated to histopathological factors and the presence of inguinal mestastasis. The influence of several histological characteristics was also correlated to inguinal disease-free survival. Results: Follow-up varied from 1 to 71 months (median 22 months). HPV DNA was identified in 60.9% of sample, with higher prevalence of types 11 and 6 (64% and 32%, respectively). There was no significant correlation of the histological characteristics of worse prognosis of penile cancer with HPV status. Inguinal disease-free survival in 5 years did also not show HPV status influence (p = 0.45). The only independent pathologic factors of inguinal metastasis were: stage T ≥ T1b-T4 (p = 0.02), lymphovascular invasion (p = 0.04) and infiltrative invasion (p = 0.03). Conclusions: HPV status and distribution had shown no correlation with worse prognosis of histological aspects, or predictive value for lymphatic metastasis in penile carcinoma.

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“…For example, Gonzaga-Silva et al, using gamma probe in the sentinel lymph node, showed sensitivity of only 25% and 42.8% of false negative results (7).…”

Section: Introductionmentioning

confidence: 99%

Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

Fonseca¹,

Soares²,

Burbano³

et al. 2013

Int. braz j urol.

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“…The average number of inguinal lymph nodes was 9.7 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Among the 4 patients who underwent pelvic lymphadenectomy, the average number of lymph nodes removed was 11.7 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). No patient had positive pelvic lymph nodes.…”

Section: Resultsmentioning

confidence: 99%

“…Not surprisingly, the region accounts for more than half (53.02%) of the cases registered in Brazil. In comparison, whe-reas 2 or 3 new cases of PC are observed every month at the Ceará Cancer Hospital in Fortaleza (Northeastern Brazil) (6), a British practicing urologist may not see more than one new case every other year.…”

Section: Introductionmentioning

confidence: 98%

Locally advanced penile carcinoma: classic emasculation or testis-sparing surgery?

Gonzaga-Silva¹,

Lima²,

Tavares³

et al. 2012

Int. braz j urol.

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Purpose:The study evaluates the clinical and pathological fi ndings of 16 patients with locally advanced penile carcinoma (PC) submitted to emasculation, and discusses questions related to the usefulness of bilateral orchiectomy. Materials and Methods: Between 1999 and 2010, 172 patients with PC were treated. Sixteen (9%) underwent emasculation. Data were retrieved from the institution's database including age, ethnicity, date of surgery, residential setting, level of schooling, time to diagnosis, type of reconstruction, complications, tumor stage and grade, vascular and perineural invasion along with invasion of corpus cavernosum, corpus spongiosum, testicles, scrotum and urethra. Results: A total of 16 patients (average: 63.1 years) with locally advanced PC were included. All were illiterate or semiliterate rural dwellers and 87% were white. The time to diagnosis was 8-12 months. The mean follow-up time was 31.9 months (1-119). By the time of the last follow-up, only seven patients (43.75%) were alive. Tumors were pT4 (n = 6), pT3 (n = 8), pT2 (n = 2), Grade I (n = 5) and Grade II (n = 11). The histopathological examination revealed invasion of the urethra (n = 13), scrotum (n = 5) and testicles (n = 1). The surgical margin was positive in one patient. Six patients (37.5%) had vascular invasion and 11 (68.7%) had perineural invasion. Currently, only one of the former is alive. Conclusions: The fi nding of focal microscopic testicular infi ltration in only one of 32 testicles, even in the presence of clinically apparent scrotal invasion, suggests that emasculation without bilateral orchiectomy is a safe treatment option for patients with locally advanced PC.

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“…In an evaluation of 10 years experience, with dynamic sentinel node biopsy in penile carcinoma, Kroon et al [71] showed a false negative rate of 16%. In a prospective study, Gonzaga-Silva et al [72] , using an isolated gamma probe technique, showed a very low sensibility and an unacceptable false negative rate.…”

Section: Histopathologic Factors and Lymph Node Mestastasesmentioning

confidence: 98%

Prognostic factors and biomarkers of penile carcinoma

Lopes

2008

Expert Opinion on Medical Diagnostics

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Penile squamous cell carcinoma (SCC) is a rare malignancy with highest incidence in underdeveloped and developing countries. Oncogenic human papilloma virus (HPV) DNA, mainly types 16 and 18, are found in ∼ 100% of patients with uterine cervix carcinoma. The incidence of this virus in SCC and its variations range from 30.5 to 80%. Despite controversies, contrary to the cervical carcinoma, in the carcinogenesis and disease progression of SCC, HPV-dependent and HPV-independent tumors need to be considered. Lymphadenectomies continue to be the gold standard treatment of lymph node metastases. Undesirable accuracy on staging system methods and high rates of lymphadenectomy complications are the principal objections to these surgical procedures; therefore, the main issue in patients with SCC is to know who should or should not undergo lymphadenectomy. The search for primary tumor anatomopathological and biomarker risk factors for lymph node metastases, such as has occurred in other tumors, may be an important tool to select lymphadenectomies candidates better. Histological subtypes, tumor grade, growth pattern, tumor thickness, lymphatic embolization by neoplasic cells and depth of infiltration have been reported as important prognostic factors for lymph node metastases. In our series, lymphatic vascular permeation, palpable lymph node after primary tumor control (cN stage), pattern of invasion, p53 and PCNA immunoreactivity are independent lymph node metastases risk factors in the multivariate model. It is strongly recommended that patients be concentrated in specialized centers or cancer hospitals and multi-centric prospective studies carried out on tumor markers in this rare disease, in order to stage better lymph node disease and avoid unnecessary surgeries with high morbidity rates.

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The isolated gamma probe technique for sentinel node penile carcinoma detection is unreliable

Cited by 33 publications

References 14 publications

Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

Locally advanced penile carcinoma: classic emasculation or testis-sparing surgery?

Prognostic factors and biomarkers of penile carcinoma

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