학술논문

Defining the role of bilateral groin dissection for squamous cell carcinoma of the penis in South Africa
Document Type
Academic Journal
Source
South African Journal of Surgery. December, 2022, Vol. 60 Issue 4, p288, 5 p.
Subject
South Africa
Language
English
ISSN
0038-2361
Abstract
Background: The current recommendation for the management of penile cancer is that all patients with palpable groin nodes should undergo a routine lymph node dissection (LND). This study reviews our yield from LND in patients with palpable lymph nodes (LNs) and penile cancer. Methods: All patients with a penile cancer, who presented to the urology departments of St Aidan's and Grey's hospitals in KwaZulu-Natal province (KZN) were reviewed. Clinical data records and histological reports of all the patients who underwent a penectomy and inguinal lymph node dissection (ILND) were analysed. Results: A total of 93 cases of penile cancer were managed between 2014 and 2019. Of this total overall cohort, 38 patients had palpable groin nodes and underwent a bilateral ILND. The majority (84%) of these patients were human immunodeficiency virus (HIV) positive and none were circumcised. Tumour grade was mostly grade II (84%), and tumour size was an average of 6.2 cm with a range from 1.5 to 12 cm. The overall incidence of metastatic inguinal lymph nodes (ILNs) in the group undergoing dissection was 23.7%. In the remainder there was only reactive lymphadenopathy. Conclusion: ILND performed in patients with penile cancer and bilateral palpable ILN in our setting has a low yield. This might be a reflection on our high rate of HIV. Local validation of international cancer guidelines is essential prior to adopting them in the South African context. Keywords: penile cancer, inguinal lymph nodes, HIV, squamous cell carcinoma
Introduction Squamous carcinoma of the penis is a relatively uncommon urological malignancy. Even in high-income countries (HICs), the social stigma surrounding the disease means that patients generally present late, with [...]