Incidence and risk factor analysis of complications after sentinel node biopsy for penile cancer.
#penilecancer
complications
morbidity
penile cancer
risk factors
sentinel node
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
revised:
23
02
2022
received:
24
11
2021
accepted:
01
03
2022
pubmed:
9
3
2022
medline:
16
9
2022
entrez:
8
3
2022
Statut:
ppublish
Résumé
To determine the incidence and types of complications after dynamic sentinel node biopsy (DSNB) in patients with penile cancer (PeCa) and identify risk factors for the occurrence of postoperative complications. We evaluated 644 patients with PeCa (1284 DSNB procedures) with at least one clinically node negative (cN0) groin who underwent DSNB between 2011 and 2020 at a single high-volume centre. The 30- and 30-90-day postoperative complications were collected according to the modified Clavien-Dindo classification and the standardised methodology proposed by the European Association of Urology panel. Uni- and multivariable generalised linear mixed models were used to identify risk factors for the occurrence of complications per groin. A 30-day postoperative complication occurred in 14% of groins (n = 186), of which 94% were mild to moderate. Wound infection and lymphocele formation were most common. A 30-90-day postoperative complication occurred in 3.4% of the groins, all of which were mild or moderate (Grade I-II). The number of removed lymph nodes (LNs) per groin was the main independent predictor for any 30-day complications and Grade ≥II complications (odds ratio 1.40; P < 0.001). There was an increase in the probability of postoperative complications with the number of LNs removed after accounting for all confounders. Despite being less morbid than (modified) inguinal LN dissection, DSNB is still associated with a considerable risk of postoperative mild-to-moderate complications. This risk increases with increasing number of LNs removed. Further procedural refinement aimed at removing the true sentinel node(s) only, may help further reduce the morbidity of surgical staging in PeCa.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
486-495Informations de copyright
© 2022 The Authors BJU International © 2022 BJU International.
Références
Horenblas S, van Tinteren H. Squamous cell carcinoma of the penis. IV. Prognostic factors of survival: analysis of tumor, nodes and metastasis classification system. J Urol 1994; 151: 1239-43
Srinivas V, Morse MJ, Herr HW, Sogani PC, Whitmore WF. Penile cancer: relation of extent of nodal metastasis to survival. J Urol 1987; 137: 880-1
Horenblas S, van Tinteren H, Delemarre JFM, Moonen LMF, Lustig V, Kröger R. Squamous cell carcinoma of the penis: accuracy of tumor, nodes and metastasis classification system, and role of lymphangiography, computerized tomography scan and fine needle aspiration cytology. J Urol 1991; 146: 1279-83
European Association of Urology (EAU). EAU guidelines on penile cancer, 2020. Available at: https://uroweb.org/guidelines/penile-cancer. Accessed March 2022
Stuiver MM, Djajadiningrat RS, Graafland NM, Vincent AD, Lucas C, Horenblas S. Early wound complications after inguinal lymphadenectomy in penile cancer: a historical cohort study and risk-factor analysis. Eur Urol 2013; 64: 486-92
Catalona WJ. Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J Urol 1988; 140: 306-10
Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol 2009; 55: 1075-88
Horenblas S, Jansen L, Meinhardt W, Hoefnagel CA, de Jong D, Nieweg OE. Detection of occult metastasis in squamous cell carcinoma of the penis using a dynamic sentinel node procedure. J Urol 2000; 163: 100-4
Wawroschek F, Vogt H, Bachter D, Weckermann D, Hamm M, Harzmann R. First experience with gamma probe guided sentinel lymph node surgery in penile cancer. Urol Res 2000; 28: 246-9
Leijte JAP, Kroon BK, Valdés Olmos RA, Nieweg OE, Horenblas S. Reliability and safety of current dynamic sentinel node biopsy for penile carcinoma. Eur Urol 2007; 52: 170-7
Jakobsen JK, Alslev L, Ipsen P et al. DaPeCa-3: promising results of sentinel node biopsy combined with 18F-fluorodeoxyglucose positron emission tomography/computed tomography in clinically lymph node-negative patients with penile cancer - a national study from Denmark. BJU Int 2016; 118: 102-11
Dimopoulos P, Christopoulos P, Shilito S et al. Dynamic sentinel lymph node biopsy for penile cancer: a comparison between 1- and 2-day protocols. BJU Int 2016; 117: 890-6
Lam W, Alnajjar HM, La-Touche S et al. Dynamic sentinel lymph node biopsy in patients with invasive squamous cell carcinoma of the penis: a prospective study of the long-term outcome of 500 inguinal basins assessed at a single institution. Eur Urol 2013; 63: 657-63
Mitropoulos D, Artibani W, Graefen M et al. Reporting and grading of complications after urologic surgical procedures: an ad hoc EAU guidelines panel assessment and recommendations. Eur Urol 2012;61:341-9
Clavien P, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 1992; 111: 518-26
Clavien PA, Barkun J, De Oliveira ML et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250: 187-96
Dell'Oglio P, de Vries HM, Mazzone E et al. Hybrid indocyanine green-99mTc-nanocolloid for single-photon emission computed tomography and combined radio- and fluorescence-guided sentinel node biopsy in penile cancer: results of 740 inguinal basins assessed at a single institution. Eur Urol 2020; 78: 865-72
Ling A, Dawkins R, Bailey M et al. Short-term morbidity associated with sentinel lymph node biopsy in cutaneous malignant melanoma. Australas J Dermatol 2010; 51: 13-7
Solari N, Bertoglio S, Boscaneanu A et al. Sentinel lymph node biopsy in patients with malignant melanoma: analysis of post-operative complications. ANZ J Surg 2019; 89: 1041-4
Lindqvist EK, Laine E, Kamali A, Sars C, Gillgren P, Schultz I. Risk factors for post-operative complications after sentinel lymph node biopsy for cutaneous melanoma: results from a large cohort study. J Plast Reconstr Aesthetic Surg 2019; 72: 1956-62
Roaten JB, Pearlman N, Gonzalez R, Gonzalez R, McCarter MD. Identifying risk factors for complications following sentinel lymph node biopsy for melanoma. Arch Surg 2005; 140: 85-9
Gopman JM, Djajadiningrat RS, Baumgarten AS et al. Predicting postoperative complications of inguinal lymph node dissection for penile cancer in an international multicentre cohort. BJU Int 2015; 116: 196-201
Dell'Oglio P, Mazzone E, Lambert E et al. The effect of surgical experience on perioperative and oncological outcomes after robot-assisted radical cystectomy with Intracorporeal urinary diversion: evidence from a referral Centre with extensive experience in robotic surgery. Eur Urol Focus 2021; 7: 352-8
Gandaglia G, Bravi CA, Dell'Oglio P et al. The impact of implementation of the European Association of Urology guidelines panel recommendations on reporting and grading complications on perioperative outcomes after robot-assisted radical prostatectomy. Eur Urol 2018; 74: 4-7
Dell'Oglio P, Andras I, Ortega D et al. Impact of the implementation of the EAU guidelines recommendation on reporting and grading of complications in patients undergoing robot-assisted radical cystectomy: a systematic review. Eur Urol 2021; 80: 129-33
Mazzone E, D'Hondt F, Beato S et al. Robot-assisted radical cystectomy with intracorporeal urinary diversion decreases postoperative complications only in highly comorbid patients: findings that rely on a standardized methodology recommended by the European Association of Urology guidelines. World J Urol 2021; 39: 803-12
Spiess PE, Hernandez MS, Pettaway CA. Contemporary inguinal lymph node dissection: minimizing complications. World J Urol 2009; 27: 205-12
White I, Mills JK, Diggs B, Fortino J, Ellis MC, Vetto JT. Sentinel lymph node biopsy for melanoma: comparison of lymphocele rates by surgical technique. Am Surg 2013; 79: 388-92
La-Touche S, Ayres B, Lam W, Alnajjar HM, Perry M, Watkin N. Trial of ligation versus coagulation of lymphatics in dynamic inguinal sentinel lymph node biopsy for staging of squamous cell carcinoma of the penis. Ann R Coll Surg Engl 2012; 94: 344-6