JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 33

Abstracts
Group C-RILND due to palpable nodes.The five-year cancer-specific survival was calculated using Kaplan-Meier
curves for each group. Statistical difference was calculated
by the Log-rank test.
Results: The cohort comprised 262 cases. 5-year cancerspecific survival for Group A=99% (n=133), Group B=69%
(n=26) and Group C=36% (n=100). P<0.0001.Figure 1.
Adjuvant chemo/radiotherapy in Groups A, B and C was
none, 4 (15%) and 43 (42%) respectively. Four patients
with negative DSNB subsequently developed metastatic
inguinal lymph nodes but were kept in Group A. Overall
the 5-year CS survival was 74%.
Conclusion: Patients with cN0 disease and no metastases on DSNB have excellent 5-year cancer-specific survival rates. Despite presenting with cN0 disease, patients
requiring a RILND for micrometastases still have a significantly reduced 5-year survival although better outcomes
than those with palpable disease.
P3-6 Management of the clinically negative
contralateral groin when the ipsilateral groin
is clinically and pathologically positive in
squamous cell carcinoma of the penis
Ager M1, Manjunath A1, Yan S1, Lam W1, Tinwell B1,
Corbishley C1, Ayres B1, Watkin N1
1St George's University Hospital, London, United Kingdom

Introduction & Objectives: Management of the contralateral non-palpable inguinal basin (cN0) when the ipsilateral basin is clinically and pathologically positive (cN+/
pN+) in SCC of the penis remains contentious. Our centre's practice is to perform an FNA on the cN+ groin for
pathological diagnosis followed by ipsilateral radical inguinal node dissection (ILND) with contralateral dynamic
sentinel node biopsy (DSNB). We aim to establish the
probability of the contralateral inguinal basin being pN+
when the ipsilateral side is cN+/pN+.
Methods: We reviewed our prospective DSNB database
since 2003. Patients with ipsilateral cN+/pN+ who had a
contralateral DSNB were identified. All patients were
reclassified according to TNM 7 and reviewed at MDT.The
probability of the contralateral DSNB being positive was
calculated and compared to the rate of the contralateral
basin being pN+ when the ipsilateral basin is cN0/pN+.
Chi squared test was used for statistical analysis.
Results: 614 patients underwent DSNB between 20032017. 42 patients were identified with unilateral cN+/pN+.
Of these, 16 patients (38%) had pN+ disease in the contralateral groin after DSNB. In patients with bilateral cN0 groins,
84 patients (14.6%) had a positive DSNB. 52 (9%) unilaterally
positive and 32 bilaterally positive (5.5%) (p < 0.01).
Conclusion: There is a statistically significant increased
risk of the contralateral inguinal basin being involved with
cN+/pN+ disease. The rate of 38% positivity however

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would still support our practice of contralateral DSNB by
reducing surgical morbidity in 62% of patients. We recommend using DSNB prior to groin dissection in all clinically
negative groins.
P3-7 Role of modern imaging in reducing false
negative rate of dynamic sentinel node biopsy
(DSNB) in penile cancer- a prospective study
over an 8-year period in >100 patients
Kumar V1, Natarajan M1, Sethia K1
and Norwich University Hospital, Norwich, United Kingdom

1Norfolk

Introduction: DSNB is a standard staging technique for
management of impalpable lymph nodes in penile cancer.
However, studies suggest false negative rate (FNR) is
around 10% (5-13%). We present our data on DSNB with
radiologically enhanced inclusion criteria.
Methods: 114(228 groins) consecutive patients who had
DSNB in a tertiary referral centre from Jan 2010 to 2018
were included in the study. All intermediate and high risk
patients under went Ultrasound+/-FNA and MRI/ CT to
stage their disease.We used combined clinical & radiological criteria (node size, architecture loss, irregular margins)
to stratify patients for DSNB vs ILND (Inguinal Lymph
Node Dissection).
Results: 23(20.1%) patients had Sentinel Node (SN) positive disease and 19 of them under went completion ILND.
4 patients with micro-metastatic disease, who refused
ILND, are being monitored and had no recurrence so far.
81 patients had bilateral SN negative disease. 5/10 remaining patients needed ILND by radiological criteria to
exclude metastasis. 5/10 patients had single sided drainage
and are being monitored. With mean follow-up of 45
months (range 3-96) false negative rate for DSNB is 0%. 2
patients would have had false negative result by DSNB if
only a clinical criterion is applied and 5 true negative
patients had to have ILND to exclude groin metastasis.
Conclusion: Combined clinical and radiological stratification of patients achieve 0% false negative rate for DSNB
at a mean follow-up of 45 months, with 5 patients (2.2%)
requiring additional ILND to exclude the disease. 71% of
the patients avoided the morbidity of Radical ILND.
P3-8 Bulbar urethral strictures after the
treatment of prostate cancer (CaP)
Bugeja S1, Ivaz S1, Frost A1, Dragova M1, Andrich D1,
Mundy A1
1University College London Hospitals, NHS Foundation Trust,
London, United Kingdom

Introduction: There are few reports in the literature on
isolated bulbar urethral strictures after treatment of CaP
because they often merge indistinguishably with bladder

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