PURPOSE: Routine follow-up of the groins of patients with squamous cell carcinoma of the penis (pSCC) after primary treatment consists of physical examination together with ultrasound (US) examination of the groins, followed by fine-needle aspiration cytology (FNAC) if suspicious.
Our aim was to assess the value of this routine follow-up.
MATERIALS AND METHODS: 247 patients treated from 2004-2010, who underwent a dynamic sentinel node biopsy (DSNB) only or in whom the inguinal regions were observed, were assessed with US and FNAC during follow-up. A negative result was considered true-negative if there was no evidence of metastatic disease after a follow-up of at least two years. Sensitivity, specificity, positive-predictive value and negative-predictive value of US and US-guided FNAC were calculated using standard statistical methods.
RESULTS: In 47 of 247 patients, a recurrence was diagnosed in 55 groins. In 40 of 55 groins (73%) a recurrence was detectable by physical examination. In 12 of 15 non-palpable recurrences (80%) US-guided FNAC revealed the recurrence. Two-hundred-seventeen groins were considered to be suspicious by US, followed by FNAC. FNAC was tumor-positive in 49 groins. FNAC was false-positive in one patient (following a negative completion lymphadenectomy). Sensitivity and specificity were 87.3% (48 of 55) and 99.9% (1304 of 1305), respectively.
CONCLUSION: Despite of the fact that inguinal recurrences are clinically manifest in the majority of patients, US-guided FNAC detected 80% of metastatic disease in patients with non-palpable disease and is therefore of great value in detecting lymph node metastases during follow-up.
Written by:
Djajadiningrat RS, Teertstra HJ, van Werkhoven E, van Boven HH, Horenblas S. Are you the author?
Department of Urology, Netherlands Cancer Institute, The Netherlands.
Reference: J Urol. 2013 Aug 28. pii: S0022-5347(13)05273-7.
doi: 10.1016/j.juro.2013.08.046
PubMed Abstract
PMID: 23994372
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