Histopathological examination of sentinel lymph nodes in penile cancer have varied over the first 10 years after introduction of the dynamic sentinel node (SLN) procedure in Denmark and guidelines have been sparse. The aim of this study is to investigate the impact of rigorous step sectioning of sentinel lymph nodes in penile cancer and improve guidelines METHODS AND RESULTS: Seventy-two penile squamous cell carcinoma patients undergoing SLN procedure at a single institution in the years 2000-2010 were included. The archived lymph node tissue already subjected to a standard pathological examination were retrieved and the initially negative lymph nodes were subjected to an extended step sectioning procedure. The results were compared to clinical patient outcome from a national database and subsequent pathology reports. The original histopathological examination had detected twenty-six SLN with metastasis, twenty-one macro metastases and five micro metastases. The additional step sectioning procedure of this study generated 4606 slides and seven SLN metastases were detected, two macro metastases and five micro metastases. One of the macro metastases originated from an inguinal basin where a clinical relapse had occurred. None of the other metastases detected in this study showed ipsilateral relapse during follow-up.
The results underline the value of our current practice of step sectioning sentinel lymph nodes in penile cancer and the need for histopathological routines and guidelines. The Danish national guidelines on histopathological handling of sentinel lymph nodes have been adapted to detect any potential clinically relevant metastases.
Histopathology. 2020 Sep 26 [Epub ahead of print]
Johanna Elversang, Birgitte Grønkaer Toft, Kim Predbjørn Krarup, Jakob Kristian Jakobsen
Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Department of Urology, Rigshopitalet, University of Copenhagen, Copenhagen, Denmark., Department of Urology, Aarhus University Hospital, Aarhus, Denmark.