[Diagnosis and treatment of penis cancer]

Penile cancer is a rare tumor in Europe and is therefore associated with risks of diagnostic delay for stage Ta-T1 tumors or pre-epitheliomatous lesions and of an inadequate treatment strategy. Clinical examination by palpation is essential in primary tumors to look for infiltration in the corpus spongiosum and the tunica albuginea of the corpus cavernosa of the penis, and in the lymphatic drainage areas, in particular in the upper inner quadrant of the inguinal lymph nodes. The work-up must include: a biopsy in the case of diagnostic doubt, lymph node aspiration in the case of palpable adenopathies, and whole-body computed tomography (CT). Treatment of the primary tumor can include partial amputation for tumors infiltrating the corpus cavernosa, or conservative treatment for tumors limited to the glands if the diameter is less than 30 mm, after an initial circumcision. Groups at risk of lymph node metastases have been defined as a function of the pathology results of their primary tumors. In these groups at risk, or in the case of clinical lymph node metastasis, dissection of the lymph node has an important role, permitting 5-year survival rates greater than 80 % when the number of metastatic lymph nodes is ≤ 1-2. In the case of more extensive lymph node spread, a combination of chemotherapy and surgery must be discussed in multidisciplinary meetings, especially for younger patients.