Management of Clinically Nude Negative Penile Carcinoma: Improved Survival After the Introduction of Dynamic Sentinel Node Biopsy

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Abstract
Purpose: We evaluated the clinical outcome of clinically node negative penile carcinoma managed by surveillance or further diagnosed by dynamic sentinel node biopsy with subsequent resection of lymph node metastases. Materials and Methods: From 1956 to 1994, 85 patients with primary T2-3N0M0 penile squamous cell carcinoma were treated with initial surveillance of the regional lymph nodes. From 1994 until 2001, 68 patients underwent dynamic sentinel node biopsy. Results: The 2 populations were similar in terms of patient age, clinical T stage, tumor grade, vascular invasion and infiltration depth. Disease specific 3-year survival in the surveillance and sentinel node groups was 79% and 91%, respectively (log rank test p = 0.04). Conclusions: Early detection of lymph node metastases by dynamic sentinel node biopsy and subsequent resection in clinically node negative T2–3 penile carcinoma improves survival compared with a policy of surveillance.