Abstract 4518: The use of surgical staging of inguinal lymph nodes in penile squamous cell carcinoma in the HIV era

Abstract Penile cancer is quite common in developing countries such as sub-Saharan Africa (SSA) and this high incidence in SSA has been attributed to high prevalence of Human Papilloma Virus (HPV). Additionally, Human Immunodeficiency Virus (HIV) prevalence is high in SSA and considering that HIV affects lymph nodes, this may potentially affect the clinical manifestation of draining lymph nodes in penile cancer. These lymph nodes are staged surgically by inguinal lymph node disection which is associated with high complications rates. Data on surgical staging of lymph nodes in penile cancer in SSA are scanty. We set to explore the use of surgical staging of inguinal lymph nodes in penile squamous cell carcinoma (PSCC) in a high HIV endemic setting.A prospective study was conducted from November, 2022 to January, 2024 at the University Teaching Hospital, Lusaka, Zambia. Patients with PSCC with surgically resectable tumor undergoing surgical treatment of primary tumor and inguinal lymph node dissection were recruited into the study. The questionnaire was administered to capture relevant information.Blood was collected pre operatively for HIV testing and viral load determination. The disected lymph node tissue and resected tumor were sent to the pathologist for histological determination of tumor involvement of lymph node and histopathological staging. Immunohistocehmistry was done on tumor tissue using p16 for HPV determination.Forty (40) were enrolled in the study with a median age was 53 years. Thirty-five (88%) were HIV seropositive with most HIV positive patients being virologically suppressed with antiretroviral therapy at the time of surgery. The prevelence of HPV among the participant was 65% with HPV types 16 and 35 being the most common. The prevalence of pathological lymph node metastasis (LNM) was 37.5% (12/32) in patients with clinically palpable (cN+) inguinal lymph nodes. In conclusion surgical staging of inguinal lymph nodes in patients with PSCC in the era of HIV has low yield of positive lymph node involvement with most being reactive adenopathy due do HIV infection and not the cancer Citation Format: Victor Mapulanga, Owen Ngalamika, Edford Sinkala, Mumba Chibamba. The use of surgical staging of inguinal lymph nodes in penile squamous cell carcinoma in the HIV era [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4518.