Management of regional lymph nodes in penile carcinoma. Five-year results following therapeutic groin dissections.

Twenty-two patients with squamous carcinoma of the penis underwent groin dissections for histologically proved inguinal lymph node metastases, either around the time that the primary tumor was treated (early therapeutic dissection, 14 patients) or later, after they had been clinically judged free of regional nodal metastases at diagnosis (late therapeutic dissections, 8 patients). Three- and five-year survival rates for the patients who underwent early therapeutic dissections were 71 per cent and 57 per cent, respectively, as opposed to 50 per cent and 13 per cent, respectively, for patients who underwent late therapeutic dissections. These findings suggest that a "wait and watch" policy in patients with clinically negative nodes at diagnosis is no longer justified.