Jakobsen Jakob K, Krarup Kim P, Sommer Peter, Nerstrøm Henrik, Bakholdt Vivi, Sørensen Jens A, Olsen Kasper Ø, Kromann-Andersen Bjarne, Toft Birgitte G, Høyer Søren, Bouchelouche Kirsten, Jensen Jørgen B
Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark.
BJU Int. 2016 Feb;117(2):235-43. doi: 10.1111/bju.13127. Epub 2015 May 11.
To estimate the diagnostic accuracy of sentinel lymph node biopsy (SNB) in patients with penile cancer and assess SNB complications in a national multicentre setting.
Retrospectively data were collected from records in four university centres by one medical doctor covering all SNBs performed in Denmark between 1 January 2000 and 31 December 2010. Patients had either impalpable lymph nodes (LNs) in one or both groins, or had a palpable inguinal mass from which aspiration cytology failed to reveal malignancy. Patients were injected with nanocolloid technetium and had a scintigram recorded before the SNB. The primary endpoint was LN recurrence on follow-up. The secondary endpoint was complications after SNB. Diagnostic accuracy was computed.
In all, 409 groins in 222 patients were examined by SNB. The median (interquartile range) follow-up of patients who survived was 6.6 (5-10) years. Of 343 negative groins, eight were false negatives. The sensitivity was 89.2% (95% confidence interval 79.8-95.2%) per groin. Interestingly, four of 67 T1G1 patients had a positive SNB. In all, 28 of 222 (13%) patients had complications of Clavien-Dindo grade I-IIIa.
Penile cancer SNB with a close follow-up stages LN involvement reliably and has few complications in a national multicentre setting. Inguinal LN dissection was avoided in 76% of patients.
评估前哨淋巴结活检（SNB）对阴茎癌患者的诊断准确性，并在全国多中心环境中评估SNB的并发症。
由一名医生从四个大学中心的记录中回顾性收集2000年1月1日至2010年12月31日在丹麦进行的所有SNB数据。患者腹股沟一处或双侧有不可触及的淋巴结（LN），或有可触及的腹股沟肿块，细针穿刺细胞学检查未发现恶性肿瘤。患者在SNB前注射纳米胶体锝并记录闪烁扫描图像。主要终点是随访时LN复发。次要终点是SNB后的并发症。计算诊断准确性。
总共对222例患者的409个腹股沟进行了SNB检查。存活患者的中位（四分位间距）随访时间为6.6（5 - 10）年。在343个阴性腹股沟中，有8个为假阴性。每个腹股沟的敏感性为89.2%（95%置信区间79.8 - 95.2%）。有趣的是，67例T1G1患者中有4例SNB呈阳性。总共222例（13%）患者出现Clavien-Dindo I - IIIa级并发症。
在全国多中心环境中，对阴茎癌进行SNB并密切随访可可靠地分期LN受累情况，且并发症较少。76%的患者避免了腹股沟淋巴结清扫术。
