The Risks of Lymph Node Metastasis and the Prognostic Factors in Carcinoma of the Penis: Analysis of 50 Patients Treated with Bilateral Ilioinguinal Lympha denectomy
SUNA I LEEWANSANGTONG, M.D.*, SITTIPORN SRINUALNAD, M.D.*, BANSITHI CHAIYA PRASITHI, M.D.*, TAWATCHAI TAWEEMONKONGSAP,M.D.*, SUCHAI SOONTRAPA, M.D.*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Objective : To determine the risks of inguinal and pelvic lymph node metastasis as well as the prognostic factors in carcinoma of the penis.
Method : Fifty patients with squamous cell carcinoma of the penis who consecutively underwent immediate bilateral ilioinguinal lymphadenectomy after treatment of the primary tumor. Clinical features were evaluated to determine the risk of inguinal and pelvic lymph node metastasis as well as prognostic factors.
Results : Patients with palpable inguinal lymph node had a high risk of inguinal lymph node metastasis compared with patients with a non palpable inguinal lymph node (p = 0.002). Patients with poor differentiated tumors had a high risk of pelvic lymph node metastasis compared with patients with well or moderately differentiated tumors (p = 0.021). Prognostic factors significantly related to survival were the clinical status of the inguinal lymph node, histological grade and the status of lymph node metastasis (N stage). None of the patients with stage NO and Nl died with the longest follow-up at 85 and 67 months, respectively. Cumulative survivals were 0.6 at follow-up at 36 months for the patients with stage N2 and 0.5 at follow-up at 18 months for patients with stage N3.
Conclusion : The clinical status of inguinal lymph node was related to the risk of inguinal lymph node metastasis. Histological grade was related to the risk of pelvic lymph node metastasis. The clinical status of the inguinal lymph node, histological grade and pathological N stage were the important factors affecting the prognosis.
Keywords : Carcinoma, Penis Neoplasm, Lymphadenectomy
