Predicting regional lymph node metastasis in Chinese patients with penile squamous cell carcinoma: the role of histopathological classification, tumor stage and depth of invasion.

PURPOSE: We determined whether histological factors of primary penile squamous cell carcinoma could predict the risk of regional lymph node metastasis.

MATERIALS AND METHODS: The clinical records of 72 consecutive Chinese patients with squamous cell carcinoma of the penis were analyzed retrospectively. Of the patients 58 underwent bilateral inguinal lymph node dissection, of whom 9 also underwent unilateral or bilateral pelvic lymph node dissection. Primary lesions were evaluated according to recently revised standards. The variables recorded were histopathological classification, histological grade, pathological tumor stage, invasion depth, vascular invasion, and the number and position of metastatic lymph nodes.

RESULTS: No patients with verrucous carcinoma had regional lymph node metastasis. However, 100% of patients with basaloid, 33.3% with warty and 30% with typical squamous cell carcinoma had lymph node metastasis (p = 0.002). The rate of lymph node metastasis was 18.8% in patients with pT1, as compared with 53.1% in patients with pT2 or pT3 (p = 0.004). The mean depth of invasion was 9.3 (range 2 to 22) vs 3.2 mm (range 1 to 6) in patients with and without lymph node metastasis, respectively (p < 0.001).

CONCLUSIONS: Histopathological classification, pathological tumor stage and depth of invasion of the primary lesion are significant predictors of regional lymph node metastasis in Chinese patients with penile squamous cell carcinoma. Combining these predictors can be used to select patients who are the best candidates for regional lymphadenectomy.