Surgical management of the clinically negative and locally advanced inguinal region in patients with squamous penile cancer

Curtis Pettaway, Lance Pagliaro

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The presence and extent of metastasis to the inguinal region are the most important prognostic factors for survival among patients with squamous penile cancer. These findings affect the prognosis of the disease more than tumor grade, gross appearance, and morphologic or microscopic patterns of the primary tumor. Unlike many other genitourinary tumors, which mandate systemic therapeutic strategies once metastasis has occurred, lymphadenectomy alone can be curative and should be performed. The biology of squamous penile cancer is such that it exhibits a prolonged locoregional phase before distant dissemination, providing a rationale for the therapeutic value of lymphadenectomy. However, owing to the morbidity of traditional lymphadenectomy, especially among those patients with a clinically negative groin, contemporary controversial issues include (1) the selection of patients for lymphadenectomy vs. careful observation, (2) the types of procedures to correctly stage the inguinal region with low morbidity, and (3) multimodal strategies to improve survival among patients with bulky inguinal metastases. In this chapter, we will focus on the surgical evaluation and management of the inguinal region among penile cancer patients with either no palpable adenopathy or those with suspected or proven advanced regional metastases.

Original languageEnglish (US)
Title of host publicationManagement of Penile Cancer
PublisherSpringer New York
Pages153-171
Number of pages19
ISBN (Electronic)9781493904617
ISBN (Print)1493904604, 9781493904600
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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