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Yasushi Yumura, Jun Kasuga, Takashi Kawahara, Yasuhide Miyoshi, Junichi Teranishi, Yusuke Hattori, Daiji Takamoto, Taku Mochizuki and Hiroji Uemura
Objective: We investigated complications related to modify inguinal lymph node dissection (ILND) for penile squamous cell carcinoma (PSCC). Modified ILND was performed for poor performance status, groins with contralateral impalpable nodes in unilateral palpable nodes, and conventional indications.
Methods: From April 2011 to November 2016, modified ILND was performed at the Yokohama City University Medical Center and its hospital for 16 groins of 12 patients with penile cancer. Seventeen groins of 11 patients who underwent radical ILND were compared (control group).
Results: The mean age of 12 patients at surgery was 67.2 years; mean follow-up was 17.1 months. Skin edge necrosis was observed in 18.8% (3/16) in the modified ILND group. However, the percentage of skin necrosis in the radical ILND group was 94.1% (16/17), which was significantly higher than that in the modified group. The mean duration of drain placement was 6.7 ± 2.6 days, which was significantly shorter than that of the radical ILND group (p=0.005). The incidence of leg edema was 25.0%; leg edema had no influence on walking in any case. One patient died of local recurrence and two died of distant metastasis. No locoregional recurrence was reported after modified ILND. The remaining patients survived with no evidence of disease.
Conclusion: Complications occurred less often for modified ILND than for radical ILND. Modified ILND might be a substitute for radical ILND in PSCC patients when dissection of impalpable intermediate-risk or high-risk nodes cannot be performed.