Eighteen sentinel lymph node biopsies were performed in 10 patients with invasive squamous carcinoma of the penis. Five of 15 biopsies associated with inguinal lymphadenopathy and 2 of 3 biopsies associated with palpably normal inguinal nodes were positive. Among 7 ipsilateral regional lymphadenectomies undertaken because of a positive biopsy, additional lymph node metastases were uncovered in only 1 instance. Among 5 patients with negative biopsies bilaterally, none had other superficial inguinal lymph node metastases and all but one have remained free of tumor (mean follow-up 26 months). These data support the possibility that the sentinel lymph node is often the first site of regional lymphatic metastasis in penile cancer.
