Predictive pathological factors of lymph nodes involvement in the squamous cell carcinoma of the penis

Objectives: To evaluate the predictive role of primary tumor histopathological features in predicting inguinal lymph nodes involvement in patients with penile squamous cell carcinoma. Material and methods: We retrospectively analysed pathological records from 30 consecutive patients who underwent penectomy for invasive squamous cell carcinoma of the penis. All histological specimens were reviewed by the same pathologist. We considered the following histological parameters: histological grading, growth pattern, deph invasion, tumour thickness, nuclear grading, poorly differentiated cancer rate, vascular and lymphatic embolization, eosinophilic and mononuclear infiltration and pathological stage. Results: Lymph nodes involvement occurred in 5 patients who underwent 'early' lymphadenectomy and in other 4 ones during oncological surveillance. Lymph nodes metastasis resulted significantly correlated with histological grading (p = 0.005), lymphatic (p = 0.005) and venous (p = 0.02) embolization, corpora cavernosa (p = 0.03) and urethra (p = 0.03) infiltration. Histological grading and lymphatic embolization were independent predictive variables of lymph nodes involvement (p = 0.02). Conclusions: The histological grading and lymphatic embolization have to be considered as important parameters to select patients with penile squamous cell carcinoma to undergo an 'early' lymphadenectomy.