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Penile cancer: a case for guidelines.

N P Munro1, P J Thomas, G P Deutsch

  • 1Department of Urology, Royal Sussex County Hospital, Brighton, UK. n.munro@icrf.icnet.uk

Annals of the Royal College of Surgeons of England
|July 4, 2001
PubMed
Summary
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Management of early penile cancer is controversial, with varied treatments like amputation and penis-conserving techniques (PCT) showing similar outcomes. Further research is needed to improve patient survival and reduce disease progression.

Area of Science:

  • Oncology
  • Urology

Background:

  • Penile cancer management, particularly for early T1 N0 disease, lacks consensus.
  • Treatment options include amputation and various penis-conserving techniques (PCT) such as local excision, laser therapy, chemotherapy, and radiotherapy.

Purpose of the Study:

  • To report on a retrospective series of patients with penile cancer.
  • To analyze treatment modalities and outcomes for penile cancer patients.

Main Methods:

  • Retrospective review of 37 penile cancer patients diagnosed between 1987-1996.
  • Data collected included TNM stage, histological grade, treatment received, and outcomes (death, nodal progression, local recurrence).

Main Results:

  • Median follow-up was 42 months; 70% presented with T1 disease, and 30% had inguinal nodal disease.

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  • Treatment modalities included penile amputation (13), radiotherapy (13), combined radiotherapy and excision (6), and local excision alone (3).
  • Overall, 15 patients died (12 from penile cancer), 10 experienced disease progression, and 12 remained disease-free. For T1 N0 disease, local recurrence or nodal spread occurred in 10 patients, with 57% disease-free overall.

    • Conclusions:

    • Patient and disease characteristics were similar to published European and North American series.
    • Significant variability in treatment modalities was observed, with local recurrence and progression in 43% of T1 N0 lesions, indicating room for improvement.
    • Retrospective data are inconclusive; urgent randomized controlled trials are needed to establish best practices for penile cancer management.