Anatomic Aspects of Inguinal Lymph Nodes Applied to Lymphadenectomy in Penile Cancer

Abstract

Objectives. To provide a better understanding of the distribution of inguinal nodes in order to prevent the complications of unnecessary and extended dissections in penile cancer. Methods. The bilateral inguinal regions of 19 male cadavers were dissected. Nodal distribution was noted and quantified based on anatomical location. The superficial nodes were subdivided into quarters as follows: superomedial, superolateral, inferomedial, and inferolateral. Statistical analysis was performed comparing node distribution between quarters using one-way analysis of variance (ANOVA), and the unpaired T-test was used between superficial and deep nodes. Results. Superficial nodes were found in all inguinal regions studied (mean = 13.60), and their distribution was more prominent in the superomedial quarter (mean = 3.94) and less in the inferolateral quarter (mean = 2.73). There was statistical significance between quarters when comparing the upper group with the lower one (P = 0.02). Nodes were widely distributed in the superficial region compared with deep lymph nodes (mean = 13.60 versus 1.71, P < 0.001). Conclusions. A great number of inguinal lymph nodes are distributed near the classical anatomical landmarks for inguinal lymphadenectomy, more prominent in upper quadrants.