First experience with gamma probe guided sentinel lymph node surgery in penile cancer |
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Authors: | Friedhelm Wawroschek Harry Vogt Dieter Bachter Dorothea Weckermann Michael Hamm Rolf Harzmann |
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Affiliation: | (1) Department of Urology, Zentralklinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany Tel.: +49-821-4002848; Fax: +49-821-4004578, DE;(2) Department of Nuclear Medicine, Zentralklinikum Augsburg, Augsburg, Germany, DE;(3) Department of Dermatology, Zentralklinikum Augsburg, Augsburg, Germany, DE |
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Abstract: | Because of the curative approach, the detection of lymph node metastases in squamous cell carcinoma (SCC) of the penis is
of significant clinical relevance. Sentinel lymph node (SLN) identification by means of lymphangiography has been proven to
be insufficiently safe. However, the high morbidity of inguinal lymphadenectomy and the considerable individual variability
regarding the location of lymph node metastases justify the necessity of a technique that enables the identification of SLNs.
Since 1998, SLNs have been intraoperatively identified and selectively dissected, after peritumoral injection of technetium-99m
nanocolloid and using lymphoscintigraphy, in three patients (one with malignant melanoma and two with SCC). At least one SLN
could be detected in each patient. The maximum surgical time was 30 min. There were no severe complications. Lymph node metastases
did not occur in any patient. Upon a mean follow-up of 10 months, all patients are currently free of tumor. Owing to the long-term
results of sentinel lymphadenectomy in malignant melanoma of other locations and our preliminary results with respect to penile
carcinoma, we consider the current method appropriate as the only primary operation for lymph node staging in early stages
and, in combination with modified inguinal lymphadenectomy, in locally advanced stages.
Received: 24 November 1999 / Accepted: 21 April 2000 |
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Keywords: | Penile neoplasms Lymph node excision Radio nuclide imaging |
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