(UroToday.com) Inguinal lymph node dissection is a core component in the management of penile squamous cell carcinoma with involvement, or a high risk of involvement, of the inguinal lymph nodes. The National Comprehensive Cancer Network (NCCN), guidelines recommend bilateral inguinal lymph node dissection for patients with clinically positive solitary non-bulky unilateral inguinal lymph nodes (cN1), and neoadjuvant chemotherapy for patients with clinically positive bilateral inguinal or any pelvic lymph nodes.
Available information is lacking regarding the risk of upstaging from cN1 to pN2/N3 at the time of inguinal lymph node dissection. Patients upstaged to pN2/N3 are in a significantly higher-risk disease state and may have derived benefit from the pre-inguinal lymph node dissection identification of upstaging, potentially qualifying them for neoadjuvant chemotherapy or clinical trials. At the 2020 SUO virtual annual meeting, Dr. Nicholas Chakiryan and colleagues presented the work of their study assessing the risk factors and survival outcomes associated with upstaging from cN1 to pN2/N3 at inguinal lymph node dissection.