GSRGT 2020: Aggressive Surgical Approach for Nodal Disease
(UroToday.com) As part of the penile cancer session at the inaugural Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit, Dr. Maarten Albersen from Belgium discussed aggressive surgical approaches for managing patients with nodal disease. Dr. Albersen notes that risk of nodal metastasis is based on the European Association of Urology (EAU) risk delineation:
EAU good risk (pT1G1): 0% risk
EAU intermediate risk (pT1G2): 9% risk
EAU high risk (≥ pT2, G3, or LVI): 23% risk
Indeed, appropriate staging of the inguinal lymph nodes is crucial to management. Dynamic sentinel biopsy is one option but has a high false-negative rate outside of high-volume centers. The National Comprehensive Cancer Network (NCCN) guidelines suggest that 20 procedures performed annually should be the baseline, with a steep learning curve of ~30-50 cases. Comparatively, inguinal lymph node dissection has a low false-negative rat