A 58-year-old man undergoes partial penectomy for a squamous cell carcinoma of the glans penis staged pT1b (high grade). Both inguinal regions are clinically and radiologically node negative. What is the recommended management of the inguinal nodes?
- A Dynamic sentinel lymph node biopsy ✓
- B Bilateral radical inguinal lymphadenectomy
- C Observation alone with no further nodal assessment
- D Prophylactic radiotherapy to both groins
Correct answer: A. Dynamic sentinel lymph node biopsy
Explanation
For clinically node-negative groins in intermediate and high-risk penile cancer such as pT1b or any grade 3 tumour, dynamic sentinel lymph node biopsy is the recommended staging procedure because occult metastasis is common and observation carries a high risk of losing resectability. Radical inguinal lymphadenectomy is reserved for proven nodal disease, where it is therapeutic. Observation is acceptable only for truly low-risk tumours such as pT1a grade 1 lesions, and prophylactic radiotherapy is not standard.
Reference: Campbell-Walsh Urology, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.