Organ-sparing surgery for invasive penile cancer: early follow-up data

To present early outcome data from patients treated for invasive penile cancers with organ-sparing surgery, as the treatment of such malignancies has traditionally either been amputative surgery or radical radiotherapy, both associated with significant physical and psychosexual morbidity.

A consecutive series of patients referred over a 3-year period for the treatment of penile malignancy were analysed prospectively. After clinical staging and grading, those patients requiring surgery were offered either a glans-preserving or a glans-removing procedure.

Of the 78 patients referred, 49 required surgery, with penile-preserving procedures in 39 of them; 32 were newly diagnosed tumours and seven were recurrences after radiotherapy. The tumour grade and stage were G1 in 11, G2 in 17 and G3 in 10 (one had melanoma and was not graded); and Ta in two, T1 in 19, T2 in 17 and T3 in one. The mean follow-up was 16 months, with nine patients followed for > or = 2 years. Complications included two patients who required immediate revisional surgery for positive resection margins, and one with radio-necrosis. One patient who had a glans-preserving procedure developed a recurrence, whereas none of those who had the glans removed did so.

With careful patient selection and meticulous follow-up, most patients with invasive penile carcinoma can be offered penile-preserving surgery.