EXPANDED CRITERIA FOR VIDEO ENDOSCOPIC INGUINAL LYMPHADENECTOMY (VEIL) IN PENILE CANCER: PALPABLE LYMPH NODES
Alexandre Stievano Carlos, Pedro Romanelli, Ricardo Nishimoto, Luis M. Montoya, CÚsar Augusto Braz Juliano, Renato Meirelles M. da Costa Jr., Antonio C. L. Pompeo, Marcos Tobias-Machado
ABC Medical School (ASC, CABJ, RMMCJr, ACLP, MTM), Santo André; Alberto Cavalcanti Hospital (PR, RN), Belo Horizonte, MG, Brazil and National Institute of Neoplastic Diseases (LMM), Lima, Peru
Introduction: Open inguinal lymphadenectomy is the gold standard for the treatment of inguinal metastasis in patients with penile cancer (PC). Recently the Video Endoscopic Inguinal Lymphadenectomy (VEIL) was proposed as an option to reduce the morbidity of the procedure in patients without palpable inguinal lymph nodes (PILN), however the oncological equivalency in patients with PILN remains poorly studied. The aims of this video are the demonstration of VEIL in patients with PILN and present the preliminary experience comparing patients with and without PILN.
Int Braz J Urol. 2012; 39 (Video #14): 893-4
In the present video entitled “Expanded criteria for video endoscopic inguinal lymphadenectomy in penile cancer”, the authors present 2 cases of penile cancer in the patients with palpable inguinal lymphadenopathy who were managed using a video endoscopic inguinal lymphadenectomy approach (VEIL). The video nicely depicts the surgical principles and potential merits of such a minimally invasive surgical approach however I would caution the authors on stating that a VEIL approach is an oncological equivalent surgical option to managing inguinal lymph nodes in penile cancer patients with palpable lymph nodes. I believe this video and abstract would be suitable for publication if the authors could appropriately amend their conclusions by stating that VEIL remains a poorly studied surgical option to the management of palpable inguinal lymphadenopathy among penile cancer patients. In conclusion, the present video highlights that it is in fact feasible to conduct such a VEIL approach in this clinical context although its oncological efficacy remains to be determined. Lastly, the authors could encourage cooperative groups like SWOG or the EORTC and/or maybe international high volume penile cancer treatment centers to do such a prospective study which would contrast the oncological outcomes and benefits of the VEIL versus open inguinal lymphadenectomy approach in appropriately matched cohorts of patients
Philippe E. Spiess, MD