Early postoperative visits improve outcomes in inguinal lymph node dissection for penile cancer.

Abstract

To analyse postoperative outcomes after inguinal lymph node dissection (ILND) at a high-volume North American centre for penile cancer with respect to early postoperative clinic visits facilitated by virtual telemedicine. Data were retrospectively collected on patients undergoing ILND performed by a single surgeon between August 2006 and April 2024. The sample population was divided into two groups differentiated by early postoperative follow-up and compared to the previously standardised surgical follow-up pathway. The primary objective was to evaluate differences between the groups in postoperative complication rates and hospital readmissions/emergency department visit rates. The early follow-up cohort (Coho showed a statistically significant reduction in overall 30-day Clavien-Dindo scores in univariate analysis (P = 0.026) and multivariate ordinal regression (P = 0.032, odds ratio = 0.41). The early follow-up cohort further showed a statistically significant reduction in postoperative hospital readmission/emergency department visits in univariate analysis (P = 0.0382), however, logistic regression analysis controlling for age, American Society of Anesthesiologists score, and complexity of ILND showed a statistically insignificant association. The study had the inherent limitations of retrospective data collection, with incomplete data on Eastern Cooperative Oncology Group performance status (3%), body mass index (10.5%) and preoperative albumin level (34%), which are important variables in regression analyses. Our data showed a statistically significant reduction in postoperative Clavien-Dindo scores within the early follow-up group. Telemedicine can easily facilitate an early check-in point for patients undergoing a surgery that is associated with high morbidity.