ABSTRACT
Today, preoperative and intraoperative lymphatic mapping and sentinel lymph node (SLN) biopsy are important diagnostic and therapeutic tools in urologic surgical oncology, with potential applications in penile, scrotal, prostate, and testicular carcinomas.1,2 Indeed, despite increasingly wide use in other malignancies, most notably melanoma and breast cancer, the concept of the sentinel lymph node has its origins in the study of penile cancer. The concept was introduced by this author in 1976, and represented the culmination of an 8-year investigation in 100 patients, 80 with penile cancer, 10 with inflammatory conditions, and 10 normal volunteers. Based on the results of lymphangiograms, anatomic dissections, and pathologic findings, the author postulated that the lymphatic system of the penis drains initially to one or a few lymph nodes, the “sentinel lymph nodes,” and that these nodes were the primary site of metastases in penile carcinoma. A pathologically negative SLN might predict a
negative node basin in general, and might allow the avoidance of an inguinal node dissection.
