AUTHOR=Li Zai-Shang , Han Hui , Deng Chuang-Zhong , Li Yong-Hong , Wu Chong , Chen Peng , Liu Zhuo-Wei , Qin Zi-Ke , Zhou Fang-Jian 

TITLE=Pelvic Lymph Node Dissection in Penile Cancer With Inguinal Lymph Node Extranodal Extension: A Multicenter Experience

JOURNAL=Frontiers in Surgery

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.644273

DOI=10.3389/fsurg.2021.644273

ISSN=2296-875X

ABSTRACT=Abstract
Background: To determine the necessary extent of PLND in penile cancer patients with inguinal lymph node extracapsular extension (ILN-ENE).
Methods:  Penile cancer patients who underwent PLND in 15 centers from January 2006 to April 2020 were retrospectively analyzed. PLND was performed in patients with ILN-ENE.
Results: 62 patients with ILN-ENE were included in the analysis. A total of 51.6% (32/62) of patients were confirmed to have pelvic lymph node metastasis (PLNM) and 31.3% (10/32) of patients were confirmed to have multiple PLNMs. In metastases cases, 59.4% (19/32) of patients with bilateral inguinal lymph node metastasis (ILNM). According to the anatomical structure, 71.9% (23/32) of patients had PLNM in the external iliac region, 56.2% (18/32) had PLNM in the obturator region, respectively. In oligo-PLNM, 65.1% (28/43) of patients had PLNM in the external iliac region, 38.9% (15/43) had PLNM in the obturator region. A significant difference was observed between patients with the bilateral ILNM and unilateral ILNM groups in overall survival (36-month: 21.2% vs. 53.7%, P=0.023). Patients with bilateral ILNM had relatively poor metastasis-free survival comparing with unilateral ILNM (36-month: 33.0% vs. 13.9%, P=0.051).
Conclusions: The external iliac and obturator region were the most commonly affected regions in patients with ILN-ENE patients, and these regions were the only affected regions in patients with oligo-PLNM. Patients with bilateral ILNM had a high risk of PLNM and worse survival.