Cabanas R M
Cancer. 1977 Feb;39(2):456-66. doi: 10.1002/1097-0142(197702)39:2<456::aid-cncr2820390214>3.0.co;2-i.
One hundred cases were studied in detail using lymphangiograms (LAG), anatomic dissections, and/or microscopic evaluation. LAG performed via the dorsal lymphatics of the penis demonstrate the existence of specific lymph node center, the so-called sentinel lymph node (SLN). This appears to be the primary site of metastases from penile carcinoma. The SLN is visualized radiographically, on the antero-posterior view, at the junction of the femoral head and the ascending ramus of the pubis. Anatomically, the SLN is part of the lymphatic system around the superficial epigastric vein. Forty-six SLN biopsies were performed with 15 positive for metastatic disease. In these 15 patients, an inguinofemoroiliac dissection was performed; in 12 cases there was no involvement of other lymph nodes. Lymphatic channels draining into the iliac lymph nodes without first draining into the sentinel lymph node were never demonstrated, nor were the inguinal-femoral lymph nodes involved in the absence of SLN involvement. On this bases, we recommend preliminary bilateral SLN biopsy to be followed by inguinofemoroiliac dissection when biopsy of the SLN biopsy to be followed by inguinofemoroiliac dissection when biopsy of the SLN is positive. When biopsy of the SLN is negative for metastatic disease, no further surgical therapy is immediately indicated. With negative SLN, 5-year survival was 90%. When SLN alone was involved, 5-year survival was 70%. Five-year survival was 50% with both SLN and other inguinal nodes involved. When iliac metastases were also present, 3-year survival was 20%.
我们使用淋巴管造影（LAG）、解剖 dissection 和/或显微镜评估对 100 例病例进行了详细研究。通过阴茎背侧淋巴管进行的 LAG 显示存在特定的淋巴结中心，即所谓的前哨淋巴结（SLN）。这似乎是阴茎癌转移的主要部位。在前后位片上，SLN 在股骨头与耻骨升支的交界处通过放射学方法显影。从解剖学上讲，SLN 是腹壁浅静脉周围淋巴系统的一部分。进行了 46 例 SLN 活检，其中 15 例有转移性疾病阳性。在这 15 例患者中，进行了腹股沟股髂淋巴结清扫术；12 例中未发现其他淋巴结受累。从未发现淋巴管在未首先引流至前哨淋巴结的情况下直接引流至髂淋巴结，在没有 SLN 受累的情况下腹股沟股淋巴结也未受累。基于此，我们建议先行双侧 SLN 活检，若 SLN 活检阳性，则随后进行腹股沟股髂淋巴结清扫术。当 SLN 活检未发现转移性疾病时，无需立即进行进一步的手术治疗。SLN 阴性时，5 年生存率为 90%。仅 SLN 受累时，5 年生存率为 70%。SLN 和其他腹股沟淋巴结均受累时，5 年生存率为 50%。当也存在髂转移时，3 年生存率为 20%。
