This study aims to compare and organize recommendations from the most eminent international guidelines on the staging and treatment of lymph node (LN) involvement in penile cancer (PC). Early recognition and appropriate management of nodal disease remain the cornerstone of care, influencing both survival and treatment-related morbidity.
This study compares and organize recommendations form the most eminent international guidelines-including NCCN, ESMO-EURACAN, and EAU-ASCO-on the staging and treatment of lymph node involvement in penile cancer.
Open inguinal LN dissection (ILND) remains the standard treatment for not superficial cancers and its morbidity has driven interest in minimally invasive surgical approaches, such as video-endoscopic inguinal lymphadenectomy (VEIL), including its robot-assisted variant (RA-VEIL). Their role is well defined in clinically node-negative (cN0) patients but remains investigational in node-positive (cN+) cases. For cN3 disease and pelvic node involvement, multimodal strategies including chemotherapy, surgery, and radiotherapy are required.
The variability among guidelines underscores the need for collaborative efforts and high-quality prospective trials to refine and standardize treatment recommendations.
International urology and nephrology. 2025 Nov 19 [Epub ahead of print]
Achille Aveta, Vincenzo Iossa, Gianluca Spena, Roberto Contieri, Alessandro Izzo, Francesco Passaro, Antonio Tufano, Vittorio Imperatore, Sisto Perdonà , Lorenzo Romano, Carlo Giulioni, Angelo Cafarelli, Pierluigi Russo, Fabio Crocerossa, Francesco Lasorsa, Giuseppe Lucarelli, Matteo Ferro, Raffaele Balsamo, Celeste Manfredi, Davide Arcaniolo, Salvatore Siracusano, Savio Domenico Pandolfo
Department of Urology, Istituto Nazionale Tumori IRCCS, "Fondazione G. Pascale", Naples, Italy., Department of Urology, Azienda Ospedaliera "S.G. Moscati", Avellino, Italy., Department of Urology, San Carlo di Nancy Hospital, Rome, Italy., Department of Woman, Child and General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli", 81100, Naples, Italy., Urology Unit, Villa Igea Private Hospital, Ancona, Italy., Department of Urology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy., Department of Urology, Magna Graecia University of Catanzaro, 88100, Catanzaro, Italy., Urology and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area-Urology, University of Bari "Aldo Moro", 70124, Bari, Italy., Unit of Urology, Department of Health Science, University of Milan, ASST Santi Paolo and Carlo, Via A. Di Rudini 8, 20142, Milan, Italy., Urology Unit, AORN Ospedali dei Colli, Monaldi Hospital, 80131, Naples, Italy., Department of Urology, University of L'Aquila, L'Aquila, Italy., Department of Urology, University of L'Aquila, L'Aquila, Italy. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41258991