Objectives: We reviewed our series of epidermoid penile cancer to determine the predictive index of lymph node invasion and the incidence of phimosis in these patients.

Methods: We reviewed the records of 11 patients with epidermoid cancer of the penis. Six patients had been evaluated according to a protocol that included preoperative biopsy of the lesion, penile and abdominal ultrasound evaluation, CT and diagnostic lymphadenectomy for those cases suspected as having lymph node invasion. The predictive index (PI) was determined in relation to the grading of cell differentiation (G) and tumor stage (S) [PI = G+T] and the incidence of phimosis was sought during the interview.

Results: Lymph node invasion was confirmed in 2 patients with PI = 6 and in 1 patient with PI = 5. Diagnostic lymphadenectomy showed no evidence of lymphatic spread in 1 patient with PI = 3 and in another patient with PI = 4. The remaining 6 patients with PI < 2 did not undergo lymphadenectomy. Phimosis was associated in 73% of the cases.

Conclusions: PI is a reliable index for lymph node invasion. Patients with PI < 4 do not require therapeutic lymphadenectomy. Phimosis should be operated early in childhood.