[Locoregional treatment of carcinoma of the penis]

Locoregional treatment of penile carcinoma continues to be a controversy between those who advocate early treatment of lymph nodes and those who advocate delaying treatment. The present study reviews 81 cases of penile carcinoma and describes our approach to treatment of the lymph nodes. A study undertaken to compare the different treatment modalities revealed that at 71 months mean follow-up 64% of the patients submitted to inguinal lymphadenectomy were alive and disease free versus 33% of those submitted to radiotherapy. Statistical analyses comparing the survival rates revealed that the likelihood of survival at 5 years was 100% for those patients submitted to prophylactic lymphadenectomy versus 51% for those submitted to therapeutic lymphadenectomy. We can conclude that since nodal metastasis represents a worse prognosis in these patients, it is advisable to perform prophylactic or therapeutic lymphadenectomy early and, furthermore, regional treatment by radiotherapy appears to be of little use.