TY - JOUR

T1 - Lessons learned from histological step-sectioning of sentinel lymph nodes in penile cancer

AU - Elversang, Johanna

AU - Grønkær Toft, Birgitte

AU - Predbjørn Krarup, Kim

AU - Jakobsen, Jakob K.

N1 - Publisher Copyright: © 2020 John Wiley & Sons Ltd

PY - 2021

Y1 - 2021

N2 - Aims: Histopathological examination of sentinel lymph nodes in penile cancer has varied during the first 10 years after introduction of the dynamic sentinel node (SLN) procedure in Denmark, and guidelines have been sparse. The aim of this study was to investigate the impact of rigorous step-sectioning of sentinel lymph nodes in penile cancer and improve guidelines. Methods and results: Seventy-two penile squamous cell carcinoma patients undergoing SLN procedure at a single institution in 2000–2010 were included. The archived lymph node tissues already subjected to a standard pathological examination were retrieved and the initially negative lymph nodes were subjected to an extended step-sectioning procedure. The results were compared to clinical patient outcome from a national database and subsequent pathology reports. The original histopathological examination had detected 26 SLN with metastasis, 21 macro metastases and five micro metastases. The additional step-sectioning procedure of this study generated 4606 slides; seven SLN metastases, two macro metastases and five micro metastases, were detected. One of the macro metastases originated from a patient in which a clinical relapse had occurred in the same groin. None of the other metastases detected in this study showed ipsilateral relapse during follow-up. Conclusion: The results underline the value of our current practice of step-sectioning sentinel lymph nodes in penile cancer and the need for histopathological routines and guidelines. The Danish national guidelines on histopathological handling of sentinel lymph nodes have been adapted to detect any potential clinically relevant metastases.

AB - Aims: Histopathological examination of sentinel lymph nodes in penile cancer has varied during the first 10 years after introduction of the dynamic sentinel node (SLN) procedure in Denmark, and guidelines have been sparse. The aim of this study was to investigate the impact of rigorous step-sectioning of sentinel lymph nodes in penile cancer and improve guidelines. Methods and results: Seventy-two penile squamous cell carcinoma patients undergoing SLN procedure at a single institution in 2000–2010 were included. The archived lymph node tissues already subjected to a standard pathological examination were retrieved and the initially negative lymph nodes were subjected to an extended step-sectioning procedure. The results were compared to clinical patient outcome from a national database and subsequent pathology reports. The original histopathological examination had detected 26 SLN with metastasis, 21 macro metastases and five micro metastases. The additional step-sectioning procedure of this study generated 4606 slides; seven SLN metastases, two macro metastases and five micro metastases, were detected. One of the macro metastases originated from a patient in which a clinical relapse had occurred in the same groin. None of the other metastases detected in this study showed ipsilateral relapse during follow-up. Conclusion: The results underline the value of our current practice of step-sectioning sentinel lymph nodes in penile cancer and the need for histopathological routines and guidelines. The Danish national guidelines on histopathological handling of sentinel lymph nodes have been adapted to detect any potential clinically relevant metastases.

KW - lymph node metastases

KW - penile squamous cell carcinoma (PSCC)

KW - sentinel node biopsy

KW - step-sectioning

UR - http://www.scopus.com/inward/record.url?scp=85096923634&partnerID=8YFLogxK

U2 - 10.1111/his.14261

DO - 10.1111/his.14261

M3 - Journal article

C2 - 32979281

AN - SCOPUS:85096923634

VL - 78

SP - 627

EP - 633

JO - Histopathology

JF - Histopathology

SN - 0309-0167

IS - 4

ER -