학술논문
Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer
Document Type
article
Author
Marcos Tobias-Machado; Antonio A. Ornellas; Alexandre K. Hidaka; Luis G. Medina; Pablo A. L. Mattos; Ruben S. Besio; Diego Abreu; Pedro R. Castro; Ricardo H. Nishimoto; Juan Astigueta; Aurus Dourado; Roberto D. Machado; Wesley J. Magnabosco; Victor Corona-Montes; Gustavo M. Villoldo; Hamilton C. Zampolli; Anis Taha; Pericles R. Auad; Eliney F. Faria; Paulo B. O. Arantes; Alessandro Tavares; Francisco S. M. S. Nascimento; Eder S. Brazão Jr.; Maurício M. Rocha; Walter H. Costa; Vinicius Panico; Leonardo O. Reis; Roberto J. Almeida-Carrera; Rafael C. Silva; Stênio C. Zequi; José R. R. Calixto; Rene Sotelo
Source
International Brazilian Journal of Urology, Vol 49, Iss 5, Pp 580-589 (2023)
Subject
Language
English
ISSN
1677-6119
1677-5538
1677-5538
Abstract
ABSTRACT Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.