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The prognosis of squamous carcinoma of the penis depends upon the stage of disease as determined by local invasion and involvement of inguinal nodes. Three-year survivals of 48 cases were: Stage I, 95%; Stage II, 67%; Stage III, 29%; and Stage IV, 0%. Most primary lesions were treated by partial penectomy, and no patient developed local recurrence. There was a significant discrepancy between initial clinical staging and histologic staging due to the difficulty in determining node metastases. In order to detect and eliminate occult metastases an aggressive approach to the inguinal nodes is proposed, including en bloc ileo-inguinal dissection for persistent clinical adenopathy, and routine superficial inguinal node biopsy of non-palpable nodes when the primary invades the corpora. The “skin bridge” technique of node dissection has some important advantages: the groin crease is not incised, and the blood supply to the flaps is preserved.
deKernion et al. (Thu,) studied this question.