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Advances in Urology
Volume 2011, Article ID 383571, 3 pages
http://dx.doi.org/10.1155/2011/383571
Review Article

The Role of Lymph Node Fine-Needle Aspiration in Penile Cancer in the Sentinel Node Era

1Urology Unit, Department of Surgery, University of Melbourne, Austin Health, Australia
2Ludwig Institute for Cancer Research, Austin Health, Melbourne VIC 3084, Australia

Received 23 December 2010; Accepted 2 February 2011

Academic Editor: Philippe E. Spiess

Copyright © 2011 Maria Carmen Mir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Penile squamous cell carcinoma (SCC) is an uncommon condition in Western countries. Inguinal lymph nodes dissection can be curative in 20%–60% of node positive patients. However, there is a high complication rates from the dissection, thus accurate diagnosis of inguinal lymph nodes metastasis is required. Current non invasive methods to detect lymph nodes metastasis are unreliable. Dynamic Sentinel Node Biopsy (DNSB), ultrasonography (US), and fine needle aspiration (FNA) cytology were proposed to in an attempt to detect sentinel lymph node (SLN). Despite the initial high rate of false negative results, recent DSNB showed improved survival compared to wait and see policy as well as reduced mortality compared to prophylactic inguinal lymphadenectomy. In addition, the US guided FNA shown 100% of specificity in detecting clinically occult lymph nodes metastasis. We proposed an algorithm for management of lymph nodes in penile cancer and suggest that FNA with US guidance should be performed in all high risk patients and that therapeutic dissection should be performed if findings are positive.