Abstract

JERMY, SBE; CLARKE, DL; SATHIRAM, R  and  FRITTELLA, LP. Defining the role of bilateral groin dissection for squamous cell carcinoma of the penis in South Africa. S. Afr. j. surg. [online]. 2022, vol.60, n.4, pp.288-292. ISSN 2078-5151.  http://dx.doi.org/10.17159/2078-5151/SAJS3638.

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.

Keywords : penile cancer; inguinal lymph nodes; HIV; squamous cell carcinoma.

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