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Functional, oncologic, and technical outcomes after endoscopic groin dissection for penile carcinoma

Daniel J. Canter¹, Ryan W. Dobbs¹, S. Mohammed A. Jafri¹, Lindsey A. Herrel¹, Kenneth Ogan¹, Keith A. Delman², Viraj A. Master¹

1 Department of Urology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA
2 Department of Surgical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA
Address correspondence to Dr. Viraj A. Master, 1365 Clifton Road, NE, Building B, Suite 1400, Atlanta, GA 30322 USA

Canadian Journal of Urology 2012, 19(4), 6395-6400.

Abstract

Penile cancer is a rare cutaneous malignancy that frequently spreads to the regional inguinal lymph nodes with a prolonged locoregional phase. An inguinal lymph node dissection may be both diagnostic and therapeutic, even in the setting of advanced disease. Despite its proven oncologic importance and efficacy, an inguinal lymphadenectomy remains underutilized, even with the publication of guidelines advocating its use. Failure to apply this modality is most likely due to the significant morbidity associated with a traditional open approach, including flap necrosis, wound infection and debilitating lymphedema.
The risks and complications associated with an open inguinal lymph node dissection have driven several investigators to develop techniques for performing a minimally invasive endoscopic inguinal lymph node dissection that is oncologically equivalent to the ‘gold standard’ open approach, while potentially minimizing the complications traditionally seen with the open technique. In this report, we detail our technique for performing a minimally invasive endoscopic groin dissection with inguinal lymphadenectomy for penile carcinoma. We also present preliminary complication and short term oncologic data employing this surgical technique in an initial cohort of patients.

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