Management of Groin in Cancer of the Penis. Hemant B. Tongaonkar Professor & Head Urologic Oncology Services Tata Memorial Hospital, Mumbai. Penile Cancer. Presence and extent of inguinal nodal metastases most important prognostic factor for survival.
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Hemant B. Tongaonkar
Professor & Head Urologic Oncology Services Tata Memorial Hospital, Mumbai
Presence and extent of inguinal nodal metastases
most important prognostic factor for survival
Histological evaluation at surgery is the Gold Standard
No prospective or randomized trials
Srinivas 1987, Ornellas 1994
Early prophylactic better than delayed therapeutic
“Window of opportunity”
Reluctance due to morbidity
Can delayed therapeutic dissection reliably &
Effectively salvage inguinal recurrences?
Is there a role for Spiral CT or PET scan?
Unreliable method: Not recommended
Promising technique for early localization of nodal metastases
Long-term data needed
Identifies microscopic mets without morbidity
(Colberg 1997, Parra 1996)
<10% LN mets
>50% LN mets
Bilateral N0 groin
Bilateral superficial or modified inguinal LND
Node -ve Unilat +ve Bilat +ve
Conclude Unilat inguino- Bilat inguino-
pelvic LND pelvic LND
1-3 +ve 22%
>3 +ve 57%
Value of pelvic LND unproven
Patients with minimal inguinal disease & limited pelvic LN mets may benefit
80% five year survival
(Srinivas 1989, Tongaonkar 1992)
Tensor fascia lata myocutaneous flap positive inguinal nodes?
Significant reduction in early & late morbidity
? Improved disease control
RCTs to develop guidelines essential