Fluorescence diagnosis: a novel method to guide radical inguinal lymph node dissection in penile cancer

In penile cancer there is still a diagnostic dilemma between over treatment of lymph node-negative patients and the missing of occult metastases by watchful waiting. In the current study the value of fluorescence diagnosis during radical inguinal lymph node dissection was evaluated. Five patients wi...

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Published inWorld journal of urology Vol. 22; no. 2; pp. 150 - 154
Main Authors FRIMBERGER, D, LINKE, R, MEISSNER, H, STEPP, H, ZAAK, D, HUNGERHUBER, E, WAIDELICH, R, SCHMELLER, N, HOFSTETTER, A, SCHNEEDE, P
Format Journal Article
LanguageEnglish
Published Heidelberg Springer 01.06.2004
Berlin Springer Nature B.V
New York, NY
Subjects
Biological and medical sciences
Fluorescence
Follow-Up Studies
Humans
Lymph Node Excision - methods
Lymphatic Metastasis
Male
Medical sciences
Nephrology. Urinary tract diseases
Penile Neoplasms - pathology
Penile Neoplasms - surgery
Protoporphyrins
Nephrology
Guide
Lymph node
Fluorescence
Malignant tumor
Inguinal
Method
Radical
Urology
Penile diseases
Fluorescence diagnosis
Treatment
Surgery
Sentinel node
Penis cancer
Minimal invasive
Diagnosis
Lymphoscintigraphy
Male genital diseases
Dissection
Penile carcinoma
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Summary:In penile cancer there is still a diagnostic dilemma between over treatment of lymph node-negative patients and the missing of occult metastases by watchful waiting. In the current study the value of fluorescence diagnosis during radical inguinal lymph node dissection was evaluated. Five patients with penile cancer were elected to undergo groin dissection. All patients received 5-aminolevulinic acid (5-ALA) orally before the operation for fluorescence diagnosis. Intraoperatively, fluorescence detection of the lymph nodes was performed by visual detection and spectroscopy. Two of the five patients had positive inguinal lymph nodes. Fluorescence in tumor-bearing tissue was detectable in the exposed lymph nodes. Protoporphyrin IX (PPIX) is accumulated in tumor-positive lymph nodes, making fluorescence diagnosis in penile cancer possible. More studies with higher patient numbers are necessary to evaluate optimal dosage and excitation conditions to detect tumor-bearing nodes in vivo.
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ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-003-0352-1