Kroon B K, Lont A P, Valdés Olmos R A, Nieweg O E, Horenblas S
Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
J Urol. 2005 Mar;173(3):813-5. doi: 10.1097/01.ju.0000156733.99684.9c.
We report on the morbidity of dynamic sentinel lymph node biopsy (DSNB) in penile squamous cell carcinoma (SCC).
Between 1994 and 2003 DSNB was performed in 129 patients with T2 or T3 penile SCC who had 243 clinically node negative groins. Patients with groins with a tumor positive sentinel node underwent additional standard inguinal lymphadenectomy.
A total of 285 sentinel nodes were harvested in 223 explored groins. The sentinel nodes were tumor-free in 189 groins. A total of 34 standard inguinal lymphadenectomies were performed because of a tumor positive sentinel node. There were 6 regional relapses during a median followup of 50 months (range 5 to 124) resulting in a false-negative rate of 15% (6 of 40 groins). This rate was 17% when calculated per patient (6 of 35 patients). Early and/or late complications following DSNB only occurred in 7% (14 of 189) of the groins. After DSNB followed by a standard inguinal lymphadenectomy, the rate was 68% (23 of 34). All complications of DSNB were minor and easily managed.
Morbidity of DSNB in penile SCC is low. However, an in field recurrence after a negative DSNB is perhaps the greatest complication of the procedure.
我们报告阴茎鳞状细胞癌(SCC)动态前哨淋巴结活检(DSNB)的发病率。
1994年至2003年间,对129例T2或T3期阴茎SCC患者进行了DSNB,这些患者有243个临床腹股沟淋巴结阴性。腹股沟前哨淋巴结肿瘤阳性的患者接受了额外的标准腹股沟淋巴结清扫术。
在223个探查的腹股沟中总共采集了285个前哨淋巴结。189个腹股沟的前哨淋巴结无肿瘤。由于前哨淋巴结肿瘤阳性,共进行了34例标准腹股沟淋巴结清扫术。在中位随访50个月(范围5至124个月)期间有6例区域复发,假阴性率为15%(40个腹股沟中的6个)。按患者计算时该率为17%(35例患者中的6例)。DSNB后的早期和/或晚期并发症仅发生在7%(189个腹股沟中的14个)的腹股沟中。DSNB后接着进行标准腹股沟淋巴结清扫术时,该率为68%(34例中的23例)。DSNB的所有并发症均较轻微且易于处理。
阴茎SCC中DSNB的发病率较低。然而,DSNB阴性后的术野内复发可能是该手术最严重的并发症。