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The presence and extent of lymph node metastasis and primary tumor are among the most important prognostic factors in penile cancer. Researchers reviewed recent literature for alternative means of staging. While inguinal lymphadenectomy is currently the most accurate means of staging, it is associated with severe morbidity and even mortality. Recent literature was reviewed[1] for alternative means of staging.

The presence and extent of lymph node metastasis and primary tumor are among the most important prognostic factors in penile cancer. While inguinal lymphadenectomy is currently the most accurate means of staging, it is associated with severe morbidity and even mortality. Recent literature was reviewed for alternative means of staging.

Functional imaging modalities distinguish between inguinal lymph nodes with and without metastasis. The false-negative rate of dynamic sentinel lymph node biopsy has recently improved from approximately 20 to five per cent in one study. In 13 patients with penile cancer, (18)F-fluorodeoxyglucose-PET/computed tomography was 80 per cent sensitive and 100 per cent specific for lymph node metastasis, but missed micro-metastasis. In seven patients with penile cancer, MRI with lymphotrophic nanoparticles was 100 per cent sensitive and 97 per cent specific for lymph node metastasis.

Combined PET/computed tomography and sentinel lymph node biopsy may help to detect both inguinal micrometastasis and pelvic and abdominal metastasis. Since MRI is highly accurate for staging of both primary penile cancer and its lymph node metastasis,


[1] Mueller-Lisse UG, Scher B, Scherr MK, Seitz M. Department of Radiology, University of Munich, Munich, Germany. Curr Opin Urol. 2008 Jan;18(1):105-10.