The Experts below are selected from a list of 11391 Experts worldwide ranked by ideXlab platform
Simon Horenblas - One of the best experts on this subject based on the ideXlab platform.
-
accuracy of 18f fdg pet ct for diagnosing Inguinal Lymph Node involvement in penile squamous cell carcinoma systematic review and meta analysis of the literature
Clinical Nuclear Medicine, 2012Co-Authors: Ramin Sadeghi, H Gholami, Seyed Rasoul Zakavi, Vahid Reza Dabbagh Kakhki, Simon HorenblasAbstract:Purpose:Metastatic involvement of the Inguinal Lymph Nodes is associated with decreased survival and is a strong prognostic factor in penile squamous cell carcinoma. The aim of the current systematic review was to evaluate the accuracy of 18F-FDG PET/CT for Inguinal Lymph Node staging in penile squa
-
accuracy of sentinel Lymph Node biopsy for Inguinal Lymph Node staging of penile squamous cell carcinoma systematic review and meta analysis of the literature
The Journal of Urology, 2012Co-Authors: Ramin Sadeghi, H Gholami, Seyed Rasoul Zakavi, Vahid Reza Dabbagh Kakhki, K T Tabasi, Simon HorenblasAbstract:Purpose: Sentinel Lymph Node biopsy is emerging as a promising method for Inguinal Lymph Node staging of penile squamous cell carcinoma. In the current systematic review we evaluated the accuracy of sentinel Lymph Node biopsy for Inguinal Lymph Node staging of penile squamous cell carcinoma and studied possible influential factors.Materials and Methods: MEDLINE®, Scopus®, ISI®, Ovid SP®, Springer, ScienceDirect® and Google™ Scholar were searched by the key words “(penile OR penis) AND sentinel”. No date or language limitation was imposed on the search and meeting abstracts were not excluded from analysis. A random effects model was used for statistical pooling.Results: A total of 17 studies suitable for meta-analysis were detected. Three articles had 2 different subgroups of patients and each subgroup was considered as a separate study. Overall 18 studies (including the subgroups) were used for detection rate meta-analysis and 19 for sensitivity meta-analysis. The pooled detection rate was 88.3% (95% CI 8...
-
anatomical mapping of Lymphatic drainage in penile carcinoma with spect ct implications for the extent of Inguinal Lymph Node dissection
European Urology, 2008Co-Authors: Joost A P Leijte, Renato Valdes A Olmos, Omgo E Nieweg, Simon HorenblasAbstract:Abstract Background Knowledge regarding the Lymphatic drainage pattern of penile cancer is the basis for the extent of Inguinal Lymph Node dissection for this disease. Objective To prospectively analyze the Lymphatic drainage pattern of penile carcinoma using SPECT-CT and evaluate the implications for the extent of Inguinal Lymph Node dissection. Design, Setting, and Participants The Lymphatic drainage patterns of 50 patients scheduled for dynamic sentinel Node biopsy were analyzed using a hybrid SPECT-CT scanner. Measurements A total of 86 clinically Node-negative (cN0) Inguinal and pelvic regions was evaluated. The sentinel and higher-tier Nodes on SPECT-CT were divided into different zones in the groin and pelvic region. The groin was divided according to Daseler's five zones, four zones obtained by drawing a vertical and horizontal line over the saphenofemoral junction and one zone directly overlying this junction. The Nodes in the pelvic region were classified into three zones: the external iliac/obturator zone, the common iliac zone, and the paraaortal zone. Results and Limitations Lymphatic drainage was visualised in 82 of the 86 cN0 groins (95.3%). A total of 115 sentinel Nodes and 182 higher-tier Nodes was found. All sentinel Nodes were located in superior and central Inguinal zones. The higher-tier Nodes were located in the groin and pelvic region. No Lymphatic drainage was seen to the inferior two regions of the groin. A potential limitation of the study is that the unilateral Lymphatic drainage seen in some patients could be normal, but it could also be caused by blockage of Lymphatic drainage due to a grossly involved metastatic Lymph Node. Another possible limitation is that this study relies on the quality and accuracy of Lymphoscintigraphy and the subsequent sentinel Node procedure. Conclusions All sentinel and higher-tier Nodes were located in the superior and central Inguinal zones and the pelvic region. No Lymphatic drainage to the inferior Inguinal zones was seen. This suggests that the extent of Inguinal Node dissection in cN0 patients could be reduced to removal of the superior and central Inguinal zones. This may decrease the extensive morbidity associated with this procedure.
Harald J. Hoekstra - One of the best experts on this subject based on the ideXlab platform.
-
Introduction of minimally invasive Inguinal Lymph Node dissections (MILND) for melanoma
Annals of Laparoscopic and Endoscopic Surgery, 2017Co-Authors: Lukas B. Been, Harald J. HoekstraAbstract:The article by Jakub and colleagues describes the adoption of a minimally invasive Inguinal Lymph Node dissection (MILND) for stage III melanoma patients in ten large-volume centers across the United States (1).
-
Morbidity After Inguinal Lymph Node Dissections: It Is Time for a Change.
Annals of surgical oncology, 2016Co-Authors: Marloes Faut, Harald J. Hoekstra, Rianne M. Heidema, Robert J. Van Ginkel, S. Lukas B. Been, Schelto Kruijff, Barbara L. Van LeeuwenAbstract:Background Inguinal Lymph Node dissection (ILND) for stage 3 melanoma is accompanied by high wound complication rates. During the past decades, several changes in perioperative care have been instituted to decrease the incidence of these complications. This study aimed to evaluate the effect of these different care protocols on wound complications after ILND.
-
early mobilization after ilio Inguinal Lymph Node dissection for melanoma does not increase the wound complication rate
Ejso, 2013Co-Authors: Kevin Wevers, H P A M Poos, Van Robert Ginkel, Boudewijn Van Etten, Harald J. HoekstraAbstract:AIM: Ilio-Inguinal Lymph Node dissection for stage III melanoma is accompanied by a substantial amount of wound complications. Our treatment protocols changed in time in terms of postoperative bed rest prescriptions, being in chronological order Group A: 10 days with a Bohler Braun splint, Group B: 10 days without splint, and Group C: 5 days without splint. The aim of this study was to evaluate the effect of bed rest prescriptions on wound complications. METHODS: For this study, we included all patients who underwent ilio-Inguinal dissection for stage III melanoma in the period 1989-2011. Both univariate and multivariable analysis were performed to identify factors that were associated with occurrence of wound complications defined as wound infection, wound necrosis, and seroma. RESULTS: Of the 204 patients analyzed, 99 suffered one or more wound complications: 51 wound infection, 29 wound necrosis, and 39 seroma. A wound complication occurred in 26 out of 64, 51 out of 89, and 22 out of 51 patients for Group A, B, and C, respectively. Univariate analysis showed age >55 (p = 0.001) and presence of comorbidity (p = 0.002) to be associated with higher incidence of wound complications. The 5 day bed rest protocol used in group C did not significantly increase the incidence of wound complications (ref = Group A: OR = 1.18; 95%CI = 0.52-2.68, p = 0.698). CONCLUSION: Early mobilization did not significantly increase the overall wound complication rate after ilio-Inguinal Lymph Node dissection for melanoma. Age >55 and comorbidity were risk factors in univariate analysis.
-
early mobilization after ilio Inguinal Lymph Node dissection for melanoma does not increase the wound complication rate
Ejso, 2013Co-Authors: Kevin Wevers, H P A M Poos, Van Robert Ginkel, B Van Etten, Harald J. HoekstraAbstract:Aim: Ilio-Inguinal Lymph Node dissection for stage III melanoma is accompanied by a substantial amount of wound complications. Our treatment protocols changed in time in terms of postoperative bed rest prescriptions, being in chronological order Group A: 10 days with a Bohler Braun splint, Group B: 10 days without splint, and Group C: 5 days without splint. The aim of this study was to evaluate the effect of bed rest prescriptions on wound complications. Methods: For this study, we included all patients who underwent ilio-Inguinal dissection for stage III melanoma in the period 1989e2011. Both univariate and multivariable analysis were performed to identify factors that were associated with occurrence of wound complications defined as wound infection, wound necrosis, and seroma. Results: Of the 204 patients analyzed, 99 suffered one or more wound complications: 51 wound infection, 29 wound necrosis, and 39 seroma. A wound complication occurred in 26 out of 64, 51 out of 89, and 22 out of 51 patients for Group A, B, and C, respectively. Univariate analysis showed age >55 (p ¼ 0.001) and presence of comorbidity (p ¼ 0.002) to be associated with higher incidence of wound complications. The 5 day bed rest protocol used in group C did not significantly increase the incidence of wound complications (ref ¼ Group A: OR ¼ 1.18; 95%CI ¼ 0.52e2.68, p ¼ 0.698). Conclusion: Early mobilization did not significantly increase the overall wound complication rate after ilio-Inguinal Lymph Node dissection for melanoma. Age >55 and comorbidity were risk factors in univariate analysis. 2012 Elsevier Ltd. All rights reserved.
Renato Valdes A Olmos - One of the best experts on this subject based on the ideXlab platform.
-
the use of spect ct for anatomical mapping of Lymphatic drainage in vulvar cancer possible implications for the extent of Inguinal Lymph Node dissection
European Journal of Nuclear Medicine and Molecular Imaging, 2015Co-Authors: A Collarino, Maarten L Donswijk, Willemien J Van Driel, Marcel P M Stokkel, Renato Valdes A OlmosAbstract:Purpose To determine the Lymphatic drainage pattern using SPECT/CT in clinically Node-negative (cN0) patients with vulvar cancer, and to evaluate the possible implications for the extent of Inguinal Lymph Node dissection.
-
anatomical mapping of Lymphatic drainage in penile carcinoma with spect ct implications for the extent of Inguinal Lymph Node dissection
European Urology, 2008Co-Authors: Joost A P Leijte, Renato Valdes A Olmos, Omgo E Nieweg, Simon HorenblasAbstract:Abstract Background Knowledge regarding the Lymphatic drainage pattern of penile cancer is the basis for the extent of Inguinal Lymph Node dissection for this disease. Objective To prospectively analyze the Lymphatic drainage pattern of penile carcinoma using SPECT-CT and evaluate the implications for the extent of Inguinal Lymph Node dissection. Design, Setting, and Participants The Lymphatic drainage patterns of 50 patients scheduled for dynamic sentinel Node biopsy were analyzed using a hybrid SPECT-CT scanner. Measurements A total of 86 clinically Node-negative (cN0) Inguinal and pelvic regions was evaluated. The sentinel and higher-tier Nodes on SPECT-CT were divided into different zones in the groin and pelvic region. The groin was divided according to Daseler's five zones, four zones obtained by drawing a vertical and horizontal line over the saphenofemoral junction and one zone directly overlying this junction. The Nodes in the pelvic region were classified into three zones: the external iliac/obturator zone, the common iliac zone, and the paraaortal zone. Results and Limitations Lymphatic drainage was visualised in 82 of the 86 cN0 groins (95.3%). A total of 115 sentinel Nodes and 182 higher-tier Nodes was found. All sentinel Nodes were located in superior and central Inguinal zones. The higher-tier Nodes were located in the groin and pelvic region. No Lymphatic drainage was seen to the inferior two regions of the groin. A potential limitation of the study is that the unilateral Lymphatic drainage seen in some patients could be normal, but it could also be caused by blockage of Lymphatic drainage due to a grossly involved metastatic Lymph Node. Another possible limitation is that this study relies on the quality and accuracy of Lymphoscintigraphy and the subsequent sentinel Node procedure. Conclusions All sentinel and higher-tier Nodes were located in the superior and central Inguinal zones and the pelvic region. No Lymphatic drainage to the inferior Inguinal zones was seen. This suggests that the extent of Inguinal Node dissection in cN0 patients could be reduced to removal of the superior and central Inguinal zones. This may decrease the extensive morbidity associated with this procedure.
Philippe E. Spiess - One of the best experts on this subject based on the ideXlab platform.
-
Important surgical concepts and techniques in Inguinal Lymph Node dissection.
Current opinion in urology, 2019Co-Authors: Juan Chipollini, Jenny Garcia-castaneda, Alfredo Harb-de La Rosa, Salim Cheriyan, Mounsif Azizi, Philippe E. SpiessAbstract:PURPOSE OF REVIEW Penile cancer is a rare disease with significant physical and psychosocial morbidity. It has a propensity to spread to the Inguinal Lymph Nodes where it can progress to the pelvis and beyond. Here, we present a contemporary review on the surgical management of the Lymph Nodes. RECENT FINDINGS Appropriate management of the Lymph Nodes is critical, and has been shown to impact survival for these patients. Those with lower stage disease can achieve cure with Inguinal Lymph Node dissection (ILND), whereas a multidisciplinary approach is required in those with more extensive disease. Tertiary referral center should be strongly considered. Advances in surgical techniques have allowed for improved outcomes and lower morbidity postoperatively. Modified ILND can be safely performed for those with nonpalpable Nodes, whereas diagnostic sentinel Node biopsy is a good alternative in centers of experience. Minimally invasive ILND has recently gained popularity with favorable results at short-term follow-up. For those with more advanced disease, the literature remains scarce with no high-level evidence as of yet. SUMMARY Early upfront surgery appears the best way to approach men with early involvement of the Inguinal Lymph Nodes, whereas systemic therapy is typically reserved for higher volume disease. Clinical trial enrollment continues to be a priority to garner more evidence-based recommendations for this aggressive malignancy.
-
Delay to Inguinal Lymph Node Dissection Greater than 3 Months Predicts Poorer Recurrence-Free Survival for Patients with Penile Cancer
The Journal of urology, 2017Co-Authors: Juan Chipollini, Julio M. Pow-sang, Wade J. Sexton, Dominic H. Tang, Scott M. Gilbert, Michael A. Poch, Philippe E. SpiessAbstract:Purpose: To our knowledge it is unknown whether concomitant Inguinal Lymph Node dissection at the time of penectomy improves outcomes in patients with penile cancer. We analyzed predictors of regional recurrence as well as disease specific survival based on time of Inguinal Lymph Node dissection. We also determined an optimal time to perform Inguinal Lymph Node dissection.Materials and Methods: We reviewed the records of 84 consecutive patients with available nodal pathology findings. Recurrence-free and disease specific survival was estimated using the Kaplan-Meier method. Optimal time to Inguinal Lymph Node dissection was assessed by ROC curves and used for dichotomization. Cox proportional HRs were used to identify predictors of regional recurrence after Inguinal Lymph Node dissection.Results: A total of 47 (56%) and 37 patients (44%) presented with cN0 and cN+ disease, respectively, during a median followup of 21 months. A cutoff point of 3 months to perform Inguinal Lymph Node dissection was used to ...
-
Update in the surgical principles and therapeutic outcomes of Inguinal Lymph Node dissection for penile cancer
Urologic oncology, 2011Co-Authors: Cesar E. Ercole, Julio M. Pow-sang, Philippe E. SpiessAbstract:Abstract Objectives Inguinal Lymph Node dissection (ILND) for the treatment of metastatic penile squamous cell carcinoma (SCC) has historically been associated with significant morbidity. This review addresses the surgical principles and techniques to decrease its perioperative morbidity, while optimizing its oncologic outcomes. Materials and methods A review of the English scientific literature from 1966 to present was conducted using the PubMed search engine as well as of additional cited works not initially noted in the search using as keywords penile cancer, Inguinal Lymph Node dissection, Inguinal Lymph Node metastasis, morbidity, and complications. Results The contemporary outcomes of ILND in the context of penile cancer have built on the significant contributions made by surgeons and scientists worldwide. In this review, we provide a comprehensive overview of the principles of ILND optimizing oncological outcomes, while minimizing its attributable morbidity. It is hoped this review will serve as a benchmark for clinicians to approach this often highly aggressive tumor phenotype. Conclusions ILND remains an important diagnostic and therapeutic procedure for patients with penile SCC, as contemporary ILND series have reported a decrease in its associated morbidity, with the potential for further treatment outcomes in years to come. ILND can in appropriately selected patients render them disease-free, thus justifying its associated morbidity.
-
Contemporary Inguinal Lymph Node dissection: minimizing complications.
World journal of urology, 2008Co-Authors: Philippe E. Spiess, Mike Hernandez, Curtis A PettawayAbstract:Objectives This review describes the morbidity of Inguinal Lymph Node dissection (ILND) performed as part of the management of penile cancer as well as recent modifications that may reduce the incidence of complications.
A Collarino - One of the best experts on this subject based on the ideXlab platform.
-
the use of spect ct for anatomical mapping of Lymphatic drainage in vulvar cancer possible implications for the extent of Inguinal Lymph Node dissection
European Journal of Nuclear Medicine and Molecular Imaging, 2015Co-Authors: A Collarino, Maarten L Donswijk, Willemien J Van Driel, Marcel P M Stokkel, Renato Valdes A OlmosAbstract:Purpose To determine the Lymphatic drainage pattern using SPECT/CT in clinically Node-negative (cN0) patients with vulvar cancer, and to evaluate the possible implications for the extent of Inguinal Lymph Node dissection.