Management of Bulky Inguinal and Pelvic Lymph Nodes - 24/06/24

Doi : 10.1016/j.ucl.2024.03.012

Logan W. Zemp, MD ^a,^⁎ , Jan K. Rudzinski, MD ^b, Curtis A. Pettaway, MD ^c, Steve Nicholson, PhD, MRCP ^d, Philippe E. Spiess, MD ^e
^a Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
^b Catherine and Joseph Aresty Department of Urology, Institute of Urology, Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA
^c Division of Surgery, Department of Urology, The University of Texas, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1373, Houston, TX 77030, USA
^d Division of Medical Oncology, Mid- & South Essex NHS Foundation Trust, Court Road, Broomfield, Chelmsford CM1 7ET, UK
^e Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive Office 12538, Tampa, FL 33612, USA

^∗Corresponding author.

Résumé

Penile cancer with bulky inguinal metastasis has a high probability of harboring pathologically involved lymph nodes best managed in a multidisciplinary care setting. Appropriate staging with cross-sectional imaging and fine-needle aspirate cytology of suspicious nodes guide decision-making for the use of platinum-based neoadjuvant chemotherapy followed by inguinal lymph node dissection. Surgical resection plays an important diagnostic, therapeutic, and guiding role in disease management. Patients with adverse pathologic features, especially those with extranodal disease extension, may derive additional benefit from adjuvant radiotherapy.

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Keywords : Penile cancer, Squamous cell carcinoma, Metastases, Inguinal lymph nodes, Pelvic lymph nodes, Chemotherapy, Radiation therapy, Multidisciplinary care