Histological subtype is a significant predictor for inguinal lymph node metastasis in patients with penile squamous cell carcinoma

The present study aimed to investigate the relationship between histopathological subtype and the probability of inguinal lymph node metastasis （ILNM） in patients with penile squamous cell carcinoma （PSCC）. The clinical records of 198 consecutive patients with PSCC were analyzed retrospectively. Primary lesions were reevaluated according to the 2016 World Health Organization （WHO） histopathological classification. We retrieved the clinicopathological factors from the medical records including age, clinical lymph node stage, pathological tumor stage, lymphatic invasion, and nerve invasion. Uni- and multivariate logistic regression analyses were used to explore the risk factors of ILNM. Multivariate analyses identified clinical lymph node stage （P = 0.000）, pathological tumor stage （P = 0.016）, histologic grade （P = 0.000）, and risk group of histological subtypes （P = 0.029） as independent predictors for ILNM. Compared with the low-risk group of PSCC subtypes, the intermediate- （HR： 3.66, 95% CI. 1.30-10.37, P = 0.021） and high-risk groups （HR： 28.74, 95% Ch 2.37-348.54, P = 0.008） were significantly associated with ILNM. In conclusion, the histopathological subtype of the primary lesion is a significant predictor for ILNM in patients with PSCC.

Superiorly based perforator plus fl ap for inguinal defects

Aim:Inguinal block dissections for metastasis to inguinal lymph nodes and occasionally trauma are always associated with soft tissue loss over the groin region.A clinical study was undertaken to demonstrate the ability to utilize a superiorly-based perforatorflap with reliable vascularity and less donor site morbidity to cover defects in the inguinal region.Methods:A prospective study was performed on 7 patients with inguinal soft tissue defects managed in our institution from January 2013 to September 2013.During the study period,a“superiorly-based perforator plusflap”was used for soft tissue coverage over the femoral vessels in the inguinal region.Hyperbaric oxygen therapy was administered postoperatively.The postoperative period,hospital course,and follow-up after radiotherapy was documented in patients with inguinal block dissection.Results:Seven patients presented with soft tissue defects in the inguinal region.Five of the defects were secondary to prior surgery,and 2 were secondary to trauma.A superiorly-based perforator plusflap was performed in all patients.The defect sizes ranged from 9 cm×4 cm to 17 cm×8 cm.Theflap dimensions ranged from 12 cm×5 cm to 20 cm×10 cm.No secondary procedures were necessary following surgery.Postoperatively,there was no evidence of partial or totalflap loss.Noflap revisions were required,and no complications were experienced at either the donor or recipient site following radiotherapy.Patients were followed-up for 10-18 months.Conclusion:Inguinal defects require stable soft tissue coverage to withstand radiotherapy following inguinal block dissection surgery,and are susceptible to wound complications.The superiorly-based perforator plusflap technique is simple,requires little operative time,and is a reliableflap for coverage of the femoral vessels and inguinal region with improved tolerance to postoperative radiotherapy.