Sentinel node biopsy (SNB) and inguinal lymph node dissection (ILND) are central to penile cancer management, but ILND especially carries substantial morbidity. This nationwide study explores the extent and risk factors of postoperative complications after inguinal lymph node surgery in Danish penile cancer patients.
We conducted a retrospective cohort study of penile cancer patients diagnosed in Denmark 2013-2025. Surgical procedures, pathological outcomes, and complications were extracted from medical records. Univariable and multivariable logistic regression with multiple imputation was used to assess predictors of complications.
Among 745 patients, 717 underwent 1348 SNB procedures and 184 underwent 241 ILND procedures. Postoperative morbidity increased substantially with procedural extent, with complications occurring after 9% of SNB procedures and after 31% of ILND procedures. Lymphoedema developed in 47% of patients following ILND versus 9% following SNB. Increasing lymph node yield independently predicted overall complications within both SNB and ILND cohorts and was additionally associated with wound infection following SNB. For lymphoedema, ILND carried five- to nine-fold higher odds compared with SNB, while higher BMI independently predicted lymphoedema risk (OR 1.07 per kg/m2, p = 0.002).
Complications increase markedly with procedure extent. Increasing lymph node yield was associated with wound infection, while lymphoedema is primarily determined by procedure type. Poor predictive ability of patient characteristics limits pre-operative risk stratification.
International urology and nephrology. 2026 Jun 11 [Epub ahead of print]
J Mølsted, A B Als, J B Jensen, M Aagaard, J K Jakobsen
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. ., Department of Oncology, Aarhus University Hospital, Aarhus, Denmark., Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Department of Urology, Copenhagen University Hospital, Copenhagen, Denmark.