Manon T A Vreeburg,Gerben M Vaessen,Hielke M de Vries,Birthe C Heeres,Margriet C van Dijk-de Haan,Vincent van der Noort,Erik H van Muilekom,Jolien van Kesteren,Niels M Graafland,Kees Hendricksen,Bas W G van Rhijn,Henk G van der Poel,Oscar R Brouwer
{"title":"Evaluating follow-up in patients with lymph node-negative penile cancer at a high-volume centre.","authors":"Manon T A Vreeburg,Gerben M Vaessen,Hielke M de Vries,Birthe C Heeres,Margriet C van Dijk-de Haan,Vincent van der Noort,Erik H van Muilekom,Jolien van Kesteren,Niels M Graafland,Kees Hendricksen,Bas W G van Rhijn,Henk G van der Poel,Oscar R Brouwer","doi":"10.1111/bju.16838","DOIUrl":null,"url":null,"abstract":"OBJECTIVES\r\nTo evaluate the current European Association of Urology/American Society of Clinical Oncology follow-up (FU) schedule with routine use of ultrasonography (US) ± US-guided fine-needle aspiration cytology (FNAC) in patients with lymph node (LN)-negative penile squamous cell carcinoma (PSCC).\r\n\r\nPATIENTS AND METHODS\r\nWe evaluated FU outcomes for low-risk clinically LN-negative (cN0) and intermediate- to high-risk sentinel node (SN) negative (pathological N-stage [pN]0) patients with PSCC at a high-volume centre. We analysed routine inguinal US ± FNAC (in case of a suspicious LN) during FU. A competing risk analysis was performed to calculate the cumulative risk of LN metastases in these groups, with local recurrence as competing risk.\r\n\r\nRESULTS\r\nA total of 201 patients with PSCC were analysed, with 2694 inguinal US investigations being evaluated. FNAC was performed during 270 US procedures (10.0%). A LN metastasis was found in four of 270 US + FNAC procedures (1.5%, 0.2% of all US). All tumours were intermediate- to high-risk tumours. Three occurred within the first year after primary treatment, and one at 20 months. The cumulative risk of developing LN metastases in cN0 low-risk tumours was 0% (no events occurred) and in SN-negative intermediate- to high-risk group 2.0%, both at 1 year of FU. Two (out of four) patients with LN recurrence died from disease.\r\n\r\nCONCLUSION\r\nAfter adequate staging and treatment, patients with cN0/pN0 PSCC rarely develop LN metastasis during FU. As these metastases generally occur within 1 year after treatment, we recommend (3-monthly) routine inguinal US only during the first year of FU. Thereafter, the frequency of FU visits and examinations can be reduced in patients capable of self-examination of the penis, resulting in a substantial (up to a 50%) reduction of FU visits compared to current guideline recommendations.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJU International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/bju.16838","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
OBJECTIVES
To evaluate the current European Association of Urology/American Society of Clinical Oncology follow-up (FU) schedule with routine use of ultrasonography (US) ± US-guided fine-needle aspiration cytology (FNAC) in patients with lymph node (LN)-negative penile squamous cell carcinoma (PSCC).
PATIENTS AND METHODS
We evaluated FU outcomes for low-risk clinically LN-negative (cN0) and intermediate- to high-risk sentinel node (SN) negative (pathological N-stage [pN]0) patients with PSCC at a high-volume centre. We analysed routine inguinal US ± FNAC (in case of a suspicious LN) during FU. A competing risk analysis was performed to calculate the cumulative risk of LN metastases in these groups, with local recurrence as competing risk.
RESULTS
A total of 201 patients with PSCC were analysed, with 2694 inguinal US investigations being evaluated. FNAC was performed during 270 US procedures (10.0%). A LN metastasis was found in four of 270 US + FNAC procedures (1.5%, 0.2% of all US). All tumours were intermediate- to high-risk tumours. Three occurred within the first year after primary treatment, and one at 20 months. The cumulative risk of developing LN metastases in cN0 low-risk tumours was 0% (no events occurred) and in SN-negative intermediate- to high-risk group 2.0%, both at 1 year of FU. Two (out of four) patients with LN recurrence died from disease.
CONCLUSION
After adequate staging and treatment, patients with cN0/pN0 PSCC rarely develop LN metastasis during FU. As these metastases generally occur within 1 year after treatment, we recommend (3-monthly) routine inguinal US only during the first year of FU. Thereafter, the frequency of FU visits and examinations can be reduced in patients capable of self-examination of the penis, resulting in a substantial (up to a 50%) reduction of FU visits compared to current guideline recommendations.
期刊介绍:
BJUI is one of the most highly respected medical journals in the world, with a truly international range of published papers and appeal. Every issue gives invaluable practical information in the form of original articles, reviews, comments, surgical education articles, and translational science articles in the field of urology. BJUI employs topical sections, and is in full colour, making it easier to browse or search for something specific.