Penile cancer in the UK: clinical presentation and outcome in 1998/99

To use the British Association of Urological Surgeons (BAUS) Cancer Registry data to audit a cohort of patients with penile cancer, and thus evaluate current management practices in the UK.

In all, 243 patients were registered over an 18-month period shortly before the publication of the UK National Institute of Clinical Excellence cancer guidelines. Clinical data, including preceding skin disorders, the clinical presentation, management, treatment-related complications and the outcome in terms of local, nodal or distant disease recurrence, survival and cause of death, were sought from the originating clinician.

Data were obtained on 193 patients (79% of the initial population). One consultant reported five patients and the most from one centre was eight. A painless lump or ulcer was the commonest presentation; 45 patients had pre-existing skin disorders. The median age was 65.5 years and 67 patients were aged < 60 years. Squamous cell carcinoma accounted for 94% of the pathology. There were wide variations in treatment for patients of similar disease stage. Twenty-six patients had palpable regional nodes and 44 had a lymph node dissection; complications were reported in 43, including 18 of 44 having node dissection. The median follow-up was 27.7 months from the date of diagnosis. Death from penile cancer was recorded in one of 22 patients with stage 0 disease and seven of nine with stage IV disease. Positive lymph nodes had a detrimental effect on survival.

Experience in the management of penile cancer is shared by many urological surgeons in the UK. These data provide a 'baseline' against which to measure the outcome of specialist multidisciplinary team activity.