European Journal of Molecular & Clinical Medicine

Abstract

We determine if histopathological factors of the primary penile tumor can stratify the risk of the development of inguinal lymph node metastases.
Materials and Methods: Clinical records of 61 consecutive patients with squamous cell carcinoma of the penis who underwent resection of the primary lesion and either inguinal lymph node dissection or were observed for signs of recurrence (median follow-up 36 months) were reviewed.
Parameters examined included pathological tumor stage, quantified depth of invasion and, histological grade, in the primary tumor, and presence or absence of vascular invasion. Variables were compared in 19 lymph node positive and 42 lymph node negative cases.
Results: Pathological tumor stage, vascular invasion and histological grade were the strongest predictors of nodal metastasis on Univariate and multivariate regression analyses. 13 pT1 tumors none of them exhibited vascular invasion and 3 (23%) with lymph node metastases. Of 48 patients with pT2 or greater tumors 12 (25%) had vascular invasion and 16 (33%) had lymph node metastases. No other variables tested were significantly different among the patient cohorts.
Conclusions: Pathological stage of the penile tumor, vascular invasion and histological grade were independent prognostic factors for inguinal lymph node metastasis.
Prophylactic lymphadenectomy in compliant patients with pT1 lesions without vascular invasion and histological grade does not appear warranted.