Role of dynamic lymphoscintigraphy in identifying inguinal nodal metastases in penile cancer

The concept of sentinel lymph node was originally described in penile cancer. With technical developments and refinements it may have a role in staging men with penile cancer whose inguinal nodes are impalpable. We examined the current evidence supporting dynamic sentinel lymph node biopsy (DSLB). In particular we compared the false-negative rate compared to conventional inguinal lymph node dissection. Further, we discuss the advantages of the minimally invasive approach. Pioneering work in the Netherlands appears to be reducing the false-negative rates to acceptable levels. However, longer follow-up is necessary before recommending DSLB for cases of penile cancer with impalpable lymph nodes. Dynamic sentinel lymph node biopsy has great potential for avoiding the morbidity associated with inguinal lymph node dissection. More mature data is necessary prior to advocating its introduction outside of randomized controlled studies