{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:20:04Z","timestamp":1777364404663,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,21]],"date-time":"2016-12-21T00:00:00Z","timestamp":1482278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To review the management and clinical outcomes of uni\u2010 or bilateral non\u2010visualization of inguinal lymph nodes during dynamic sentinel lymph node biopsy (\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      ) in patients diagnosed with penile cancer and clinically impalpable inguinal lymph nodes (\n                      <jats:styled-content style=\"fixed-case\">cN<\/jats:styled-content>\n                      0), and to develop an algorithm for the management of patients in which non\u2010visualization occurs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      This is a retrospective observational study over a period of 4 years, comprising 166 patients with penile squamous cell carcinoma undergoing\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      and followed up for a minimum of 6 months. All cases diagnosed with uni\u2010 or bilateral non\u2010visualization of sentinel nodes in this cohort were identified from a penile cancer database. The management of the inguinal lymph nodes after non\u2010visualization and the oncological outcomes including local and regional recurrence rates were documented.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 166 consecutive patients undergoing\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      , 20 patients (12%) had unilateral non\u2010visualization after injection of intradermal\n                      <jats:sup>99m<\/jats:sup>\n                      Tc. Of these 20 patients, seven underwent repeat\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      at a later date, with six having successful visualization. One patient had persistent non\u2010visualization and proceeded to a superficial modified inguinal lymphadenectomy (\n                      <jats:styled-content style=\"fixed-case\">SML<\/jats:styled-content>\n                      ). None of these patients experienced recurrence at follow\u2010up. A further seven patients underwent modified\n                      <jats:styled-content style=\"fixed-case\">SML<\/jats:styled-content>\n                      with on\u2010table frozen\u2010section analysis of the lymph node packet; none of these patients were found to have micrometastatic disease in the inguinal lymph nodes, although one patient developed metastatic inguinal node disease at a later date. Six patients elected to undergo clinical surveillance and have remained disease\u2010free.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Patients with impalpable inguinal lymph nodes undergoing\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      with \u2265G2 T1 disease should ideally have bilateral visualization of the sentinel lymph nodes, reflecting the drainage pattern from the primary tumour. In the present series, 12% of patients were found to have unilateral non\u2010visualization after\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      . Among patients offered a repeat\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      at a later date, localizing the sentinel node was successful in 86% of cases. Patients with favourable histological characteristics can be placed on clinical surveillance. Those with high\u2010risk disease can be offered a repeat\n                      <jats:styled-content style=\"fixed-case\">DSNB<\/jats:styled-content>\n                      procedure on the proviso that\n                      <jats:styled-content style=\"fixed-case\">SML<\/jats:styled-content>\n                      may be carried out if there is repeated non\u2010visualization. Larger cohorts are required to validate this proposed algorithm.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.13680","type":"journal-article","created":{"date-parts":[[2016,10,15]],"date-time":"2016-10-15T09:22:43Z","timestamp":1476523363000},"page":"573-578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Management of non\u2010visualization following dynamic sentinel lymph node biopsy for squamous cell carcinoma of the penis"],"prefix":"10.1111","volume":"119","author":[{"given":"Varun","family":"Sahdev","sequence":"first","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten","family":"Albersen","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"},{"name":"University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Christodoulidou","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Parnham","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Malone","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Nigam","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamshed","family":"Bomanji","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine University College London Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asif","family":"Muneer","sequence":"additional","affiliation":[{"name":"Department of Urology and NIHR Biomedical Research Centre University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,12,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-008-9276-9"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-011-0802-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.09.039"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.10.017"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)35221-7"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3322\/canjclin.57.1.43"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.10.060"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20414"},{"key":"e_1_2_7_10_1","first-page":"45","article-title":"Cancer incidence in five continents. 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