Nodal Staging in Penile Carcinoma by Dynamic Sentinel Node Biopsy After Previous Therapeutic Primary Tumour Resection
Nodal Staging in Penile Carcinoma by Dynamic Sentinel Node Biopsy After Previous Therapeutic Primary Tumour Resection
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DOI：
10.1016/j.eururo.2010.06.036
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发表时间：
2010-11-01
期刊：
影响因子：
23.4
通讯作者：
Horenblas, Simon
中科院分区：
文献类型：
--
作者：
Graafland, Niels M.;Olmos, Renato A. Valdes;Horenblas, Simon
背景资料：动态前哨淋巴结活检（DSNB）用于评估阴茎癌和临床淋巴结阴性腹股沟患者的淋巴结状态。这种微创手术通常在治疗原发肿瘤的同时进行。目的：我们的目的是评估所谓的切除后DSNB的结果，即在先前切除阴茎肿瘤后的DSNB。设计，设置和参与者：所有40例在既往阴茎癌切除术后接受DSNB的患者，组织病理学肿瘤-分析了2003年2月至2009年7月期间的负利润率。20例患者（50%）已知单侧淋巴结受累，DSNB用于临床正常的对侧腹股沟分期。因此，该研究涉及60例腹股沟无可触及淋巴结。原发性肿瘤切除和DSNB之间的中位时间为2.8个月。切除术后DSNB的技术是类似的标准procedure.Measurements：前哨淋巴结可视化率，识别率，组织病理学结果，并在后续outcome.Results和限制：前哨淋巴结可视化的淋巴结造影的56 60个合格的腹股沟（93%）。术中在所有这56个腹股沟中发现了前哨淋巴结。切除了中位数为2个前哨淋巴结。组织学分析显示7例患者（18%）累及7个腹股沟（12%）。这些转移瘤的平均大小为6 mm。在一个完成的同侧腹股沟淋巴结清扫标本中发现了额外的播散。在原发性肿瘤切除后中位28个月的随访期间，已取出一个或多个无肿瘤前哨淋巴结的腹股沟没有复发。本研究的一个潜在的局限性是短期的后续行动和相对较小的队列number.Conclusions：postreference DSNB是一个合适的程序阶段临床淋巴结阴性的阴茎癌后，以前的治疗原发性肿瘤切除术。结果似乎与DSNB在肿瘤仍然存在的患者中的有利经验相似。(C)2010年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
Background: Dynamic sentinel node biopsy (DSNB) is used to evaluate the nodal status of patients with penile carcinoma and clinically node-negative groins. This minimally invasive procedure is usually done at the same time as the treatment of the primary tumour.Objective: Our aim was to evaluate results of so-called postresection DSNB, that is, DSNB after previous resection of the penile tumour.Design, setting, and participants: All 40 patients who had undergone DSNB after previous penile carcinoma resection with histopathologically tumour-negative margins between February 2003 and July 2009 were analysed. Twenty patients (50%) had known unilateral nodal involvement, and DSNB was used to stage the clinically normal contralateral groin. Hence the study concerned 60 groins without palpable nodes. The median time between primary tumour resection and DSNB was 2.8 mo. The technique of postresection DSNB was similar to the standard procedure.Measurements: The sentinel node visualisation rate, identification rate, histopathologic results, and outcome during follow-up were investigated.Results and limitations: A sentinel node was visualised on the lymphoscintigrams of 56 of the 60 eligible groins (93%). A sentinel node was identified intraoperatively in all these 56 groins. A median of two sentinel nodes were removed. Histopathologic analysis revealed involvement of seven groins (12%) in seven patients (18%). The median size of these metastases was 6 mm. Additional dissemination was found in one completed ipsilateral inguinal node dissection specimen. No recurrences developed in the groins from which one or more tumour-free sentinel nodes had been taken during a median follow-up of 28 mo after the primary tumour resection. A potential limitation of this study is the short follow-up and relatively small cohort number.Conclusions: Postresection DSNB is a suitable procedure to stage clinically node-negative penile carcinoma after previous therapeutic primary tumour resection. The results seem similar to the favourable experience with DSNB in patients with their tumour still present. (C) 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.