Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer

Tobias-Machado M.; Ornellas A.A.; Hidaka A.K.; Medina L.G.; Mattos P.A.L.; Besio R.S.; Abreu D.; Castro P.R.; Nishimoto R.H.; Astigueta J.; Dourado A.; Machado R.D.; Magnabosco W.J.; Corona-Montes V.; Villoldo G.M.; Zampolli H.C.; Taha A.; Auad P.R.; Faria E.F.; Arantes P.B.O.; Tavares A.; Nascimento F.S.M.S.; Brazão E.S., Jr.; Rocha M.M.; Costa W.H.; Panico V.; Reis L.O.; Almeida-Carrera R.J.; Silva R.C.; Zequi S.C.; Calixto J.R.R.; Sotelo R. · International Braz J Urol (2023) · DOI: 10.1590/s1677-5538.ibju.2023.0065

Resumen

Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y-overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer. © (2023), (Brazilian Society of Urology). All Rights Reserved.

Instituciones: Universidad Privada Antenor Orrego