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• W114996810 abstract "No AccessJournal of Urology1 Nov 1991Squamous 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 Simon Horenblas, Harm van Tinteren, Jan F.M. Delemarre, Luc M.F. Moonen, Vera Lustig, and Robert Kröger Simon HorenblasSimon Horenblas More articles by this author , Harm van TinterenHarm van Tinteren More articles by this author , Jan F.M. DelemarreJan F.M. Delemarre More articles by this author , Luc M.F. MoonenLuc M.F. Moonen More articles by this author , Vera LustigVera Lustig More articles by this author , and Robert KrögerRobert Kröger More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38068-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Among 118 patients with squamous cell carcinoma of the penis treated at our cancer institute between 1956 and 1989, we analyzed the accuracy of classification, using the tumor, nodes and metastasis system. We analyzed the role of lymphography, computerized tomography and fine needle aspiration cytology as additional staging procedures. The primary tumor (T category) was classified incorrectly in 26% of the cases. Understaging was noted in 10% of the cases because of unsuspected infiltration and overstaging was noted in 16%. Overstaging occurred because of edema and infection masking the actual size and giving a misconception of infiltration, and also because of primary presentation as large exophytic tumors with no or minimal histopathological infiltration. When the regional lymph nodes were categorized simply as positive or negative 80% of the tumors were classified correctly and 20% incorrectly (13% were false positive and 7% were false negative). Regional lymph node invasion that escaped clinical examination was not detected by any imaging examination or fine needle aspiration cytology study. Positive findings were found only in patients with clinically suspected nodes. The classification of regional nodes by clinical examination only is hardly improved by additional imaging studies. Clinical decisions with respect to the management of regional lymph nodes should not be based on negative findings of lymphangiography, computerized tomography or fine needle aspiration cytology. In patients with proved metastasis additional imaging may be of some help in the detection of pelvic node invasion and the determination of the extent of involvement. We recommend lymphangiography as the examination of choice. © 1991 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByO'Brien J, Perera M, Manning T, Bozin M, Cabarkapa S, Chen E and Lawrentschuk N (2018) Penile Cancer: Contemporary Lymph Node ManagementJournal of Urology, VOL. 197, NO. 6, (1387-1395), Online publication date: 1-Jun-2017.Djajadiningrat R, Teertstra H, van Werkhoven E, van Boven H and Horenblas S (2018) Ultrasound Examination and Fine Needle Aspiration Cytology—Useful for Followup of the Regional Nodes in Penile Cancer?Journal of Urology, VOL. 191, NO. 3, (652-655), Online publication date: 1-Mar-2014.Djajadiningrat R, Graafland N, van Werkhoven E, Meinhardt W, Bex A, van der Poel H, van Boven H, Valdés Olmos R and Horenblas S (2018) Contemporary Management of Regional Nodes in Penile Cancer—Improvement of Survival?Journal of Urology, VOL. 191, NO. 1, (68-73), Online publication date: 1-Jan-2014.D’ANCONA C, DE LUCENA R, DE OLIVEIRA QUERNE F, MARTINS M, DENARDI F and NETTO N (2018) LONG-TERM FOLLOWUP OF PENILE CARCINOMA TREATED WITH PENECTOMY AND BILATERAL MODIFIED INGUINAL LYMPHADENECTOMYJournal of Urology, VOL. 172, NO. 2, (498-501), Online publication date: 1-Aug-2004.JAGANMOHAN S, KHURANA V and NOPAJAROONSRI C (2018) SQUAMOUS CELL CARCINOMA OF THE PENIS PRESENTING AS A STERILE INGUINAL ABSCESSJournal of Urology, VOL. 172, NO. 5, (1877-1877), Online publication date: 1-Nov-2004.CULKIN D and BEER T (2018) Advanced Penile CarcinomaJournal of Urology, VOL. 170, NO. 2, (359-365), Online publication date: 1-Aug-2003.WINDAHL T and ANDERSSON S (2018) Combined Laser Treatment for Penile Carcinoma: Results After Long-Term FollowupJournal of Urology, VOL. 169, NO. 6, (2118-2121), Online publication date: 1-Jun-2003.SLATON J, MORGENSTERN N, LEVY D, SANTOS M, TAMBOLI P, RO J, AYALA A and PETTAWAY C (2018) TUMOR STAGE, VASCULAR INVASION AND THE PERCENTAGE OF POORLY DIFFERENTIATED CANCER: INDEPENDENT PROGNOSTICATORS FOR INGUINAL LYMPH NODE METASTASIS IN PENILE SQUAMOUS CANCERJournal of Urology, VOL. 165, NO. 4, (1138-1142), Online publication date: 1-Apr-2001.HORENBLAS S, JANSEN L, MEINHARDT W, HOEFNAGEL C, de JONG D and NIEWEG O (2018) DETECTION OF OCCULT METASTASIS IN SQUAMOUS CELL CARCINOMA OF THE PENIS USING A DYNAMIC SENTINEL NODE PROCEDUREJournal of Urology, VOL. 163, NO. 1, (100-104), Online publication date: 1-Jan-2000.Parra R (2018) Accurate Staging of Carcinoma of the Penis in Men with Nonpalpable Inguinal Lymph Nodes by Modified Inguinal LymphadenectomyJournal of Urology, VOL. 155, NO. 2, (560-563), Online publication date: 1-Feb-1996.Lopes A, Hidalgo G, Kowalski L, Torloni H, Rossi B and Fonseca F (2018) Prognostic Factors in Carcinoma of the Penis: Multivariate Analysis of 145 Patients Treated with Amputation and LymphadenectomyJournal of Urology, VOL. 156, NO. 5, (1637-1642), Online publication date: 1-Nov-1996.Windahl T and Hellsten S (2018) Laser Treatment of Localized Squamous Cell Carcinoma of the PenisJournal of Urology, VOL. 154, NO. 3, (1020-1023), Online publication date: 1-Sep-1995.Horenblas S and Van Tinteren H (2018) Squamous Cell Carcinoma of the Penis. IV. Prognostic Factors of Survival: Analysis of Tumor, Nodes and Metastasis Classification SystemJournal of Urology, VOL. 151, NO. 5, (1239-1243), Online publication date: 1-May-1994.Augusto Ornellas A, Correia Seixas A, Marota A, Wisnescky A, Campos F and de Moraes J (2018) Surgical Treatment of Invasive Squamous Cell Carcinoma of the Penis: Retrospective Analysis of 350 CasesJournal of Urology, VOL. 151, NO. 5, (1244-1249), Online publication date: 1-May-1994.Horenblas S, van Tinteren H, Delemarre J, Moonen L, Lustig V and van Waardenburg E (2018) Squamous Cell Carcinoma of the Penis. III. Treatment of Regional Lymph NodesJournal of Urology, VOL. 149, NO. 3, (492-497), Online publication date: 1-Mar-1993.Horenblas S, van Tinteren H, Delemarre J, Boon T, Moonen L and Lustig V (2018) Squamous Cell Carcinoma of the Penis. II. Treatment of the Primary TumorJournal of Urology, VOL. 147, NO. 6, (1533-1538), Online publication date: 1-Jun-1992. Volume 146Issue 5November 1991Page: 1279-1283 Advertisement Copyright & Permissions© 1991 by The American Urological Association Education and Research, Inc.Keywordspenile neoplasmslymphographycytologytomography, x-ray computedcarcinoma, squamous cellMetricsAuthor Information Simon Horenblas More articles by this author Harm van Tinteren More articles by this author Jan F.M. Delemarre More articles by this author Luc M.F. Moonen More articles by this author Vera Lustig More articles by this author Robert Kröger More articles by this author Expand All Advertisement Loading ..." @default.
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