1. Defining the role of bilateral groin dissection for squamous cell carcinoma of the penis in South Africa
- Author
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L.P. Frittella, S.B. Jermy, R. Sathiram, and D.L. Clarke
- Subjects
squamous cell carcinoma ,medicine.medical_specialty ,business.industry ,Urology ,HIV ,penile cancer ,penile cancer, inguinal lymph nodes, HIV, squamous cell carcinoma ,Surgery ,inguinal lymph nodes ,medicine.anatomical_structure ,Medicine ,Basal cell ,business ,Groin dissection ,Penis - 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.
- Published
- 2022