Management of Bulky Inguinal and Pelvic Lymph Nodes

Urol Clin North Am. 2024 Aug;51(3):335-345. doi: 10.1016/j.ucl.2024.03.012. Epub 2024 May 18.

Abstract

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.

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

Publication types

  • Review

MeSH terms

  • Humans
  • Inguinal Canal*
  • Lymph Node Excision*
  • Lymph Nodes* / pathology
  • Lymphatic Metastasis*
  • Male
  • Neoplasm Staging
  • Pelvis*
  • Penile Neoplasms* / pathology
  • Penile Neoplasms* / therapy