Treatment of Penile Squamous Cell Carcinoma with Palpable Mobile Inguinal Lymph Node Metastases (cN1–cN2)
When penile squamous cell carcinoma presents with clinically palpable, mobile inguinal lymph nodes, it defines a well-characterised nodal stage requiring active management. The staging designation—cN1 for unilateral single-node involvement or cN2 for multiple or bilateral nodes—directly shapes the treatment strategy applied.
Clinical Scenario
This protocol addresses patients with palpable mobile inguinal lymph node metastases from penile squamous cell carcinoma:
- cN1 — palpable, mobile, unilateral inguinal lymph node
- cN2 — palpable, mobile, multiple or bilateral inguinal lymph nodes
Treatment Approach
Radical inguinal lymph node dissection (ILND) is the established standard of care for both cN1 and cN2 disease, with the specific surgical approach adapted to nodal extent and laterality. For a subset of cN2 patients, a systemic therapy approach prior to surgery may be considered as an alternative — the full eligibility criteria, complete surgical decision algorithm, and all management details are in the structured protocol.
References
- cN1 Palpable mobile unilateral inguinal lymph node
- cN2 Palpable mobile multiple or bilateral inguinal lymph nodes
- Radical ILND remains the standard of care for patients with cN1–2.
- Offer neoadjuvant chemotherapy (NAC) as an alternative approach to upfront surgery to selected patients with bulky mobile inguinal nodes or bilateral disease (cN2) who are candidates for cisplatin and taxane-based chemotherapy.
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