Video-endoscopic versus open inguinal lymphadenectomy - Long-term oncological outcomes in penile cancer

Sep 30, 2026

Uploaded by Eliana

Long-term oncological follow-up compares video-endoscopic inguinal lymphadenectomy (VEILND) with open inguinal lymphadenectomy (OILND) for penile cancer patients with suspected lymph node involvement. Lymph node metastasis status is identified as the strongest predictor of survival, and VEILND’s long-term efficacy was previously unproven despite favorable short-term surgical outcomes. Outcomes from 42 prospectively tracked patients treated between 2008 and 2015 are evaluated using Kaplan–Meier survival curves and log-rank testing.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

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Introduction

Methods

Results

Conclusion

DOI: 10.1002/bco2.70153 ORIGINA L ARTICLE Video-endoscopic versus open inguinal lymphadenectomy: Long-term oncological outcomes in penile cancer Ranya Kumar 1 | Krishna Sethia 2,3 | Vivekanandan Kumar 2,3 1School of Clinical Medicine, University of Cambridge, Cambridge, UK 2Norfolk and Norwich University Hospitals NHS Trust, Norwich, UK 3University of East Anglia, Norwich, UK Correspondence Ranya Kumar, School of Clinical Medicine, University of Cambridge, Cambridge, UK. Email: [rvk25@cam.ac.uk](rvk25@cam.ac.uk) Funding information None. Abstract Introduction: Lymph node metastasis status is the strongest predictive factor for penile cancer survival. In penile cancer patients with suspected lymph node involvement, inguinal lymph node dissection (ILND) extends disease-free survival. Though video-endoscopic ILND (VEILND) has demonstrated superior surgical outcomes to open ILND (OILND) in the short term, its oncological efficacy long term is unproven. We present our long-term oncological follow-up of our previously published ILND cohort. Methods: A prospectively collected institutional database was used to determine the outcome in 42 consecutive patients treated for penile cancer in a tertiary referral centre between 2008 and 2015 . Overall survival and cancer-specific survival (CSS) were calculated using Kaplan–Meier curves and compared via log-rank tests. Results: Forty-two patients underwent 68 ILND (35 OILND vs. 33 VEILND) . Thirteen out of 42 patients were alive at a mean follow-up of 12 . 5 years. Overall survival for OILND and VEILND was 36 .4% and 30 .0% at 10 years. There was no significant difference between the survival curves ( p = 0.91) . CSS was equivalent (p = 0.87) . Tenyear CSS was 75 .3%(OILND) and 65 . 5%(VEILND) . When stratified by nodal status, CSS for OILND was 77.8%, 83.3%, 50% and 66.7%(N0, N1, N2 and N3) compared with VEILND which were 100%, 75%, 75% and 40% respectively at 8 years. Thus, there was no significant difference in CSS between patients undergoing VEILND and OILND stratified by nodal status. Moreover, inguinal or pelvic nodal recurrence rate was equivalent in both groups, occurring in 5/22 OILND and 4/20 VEILND ( p = 1.00) patients. Conclusion: To our knowledge, we present the first European report of long-term follow-up demonstrating the oncological safety of VEILND. VEILND has comparable outcomes of recurrence, overall survival and CSS, with significantly reduced complication rates and length of stay, in penile cancer at a median follow-up of 104 months (range 2–213 months) . KEYW OR DS inguinal lymph node dissection, nodal status, open ILND, penile cancer, survival, videoendoscopic This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2026 The Author(s) . BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company. BJUI Compass. 2026;7:e70153 . [https://doi.org/10.1002/bco2.70153](https://doi.org/10.1002/bco2.70153) [wileyonlinelibrary.com/journal/bco2](wileyonlinelibrary.com/journal/bco2) 1 of 7 1 | INTRODUCTION In the Western world, the incidence of penile cancer is significantly lower (0.4–1 per 100 000) than in the Eastern world (1.3 per 100 000) . 1,2 Studies have shown that lymph node metastasis status is the strongest predictive factor for penile cancer survival.3 In patients with palpable inguinal nodes, 70% to 90% harbour metastatic disease. In such patients with suspected lymph node involvement, inguinal lymph node dissection (ILND) extends disease-free survival.4 Open radical ILND is the standard of care for node clearance. However, it has a very high complication rate ranging from 30% to 75% .5 Several modifications have been practiced to reduce the complication rate including the use of modified radical6 and fascial sparing7 approaches for ILND. Thes

FAQs

Why is inguinal lymph node dissection important in penile cancer survival?

Lymph node metastasis status is the strongest predictive factor for penile cancer survival, and ILND extends disease-free survival in patients with suspected nodal involvement.

How were overall survival and cancer-specific survival compared between VEILND and OILND?

Overall survival and cancer-specific survival were calculated using Kaplan–Meier curves and compared via log-rank tests.

What long-term oncological differences were found between VEILND and OILND?

No significant differences were reported for overall survival or cancer-specific survival between the two approaches, and inguinal or pelvic nodal recurrence rates were equivalent.

Sep 30, 2026

Uploaded by Eliana