Penile sparing surgery for penile cancer-does it affect survival?

Area of Science:

• Oncology
• Surgical Oncology
• Urology

Background:

• Penile squamous cell carcinoma (PSCC) management has evolved.
• Shift towards less invasive surgical approaches, favoring penile preservation over amputation.

Purpose of the Study:

• To evaluate the trend of penile sparing surgery (PSS) application in PSCC over time.
• To determine the impact of PSS on 5-year cancer-specific survival (CSS).

Main Methods:

• Retrospective analysis of 859 patients with invasive PSCC (1956-2012).
• Tumor staging using 2009 TNM classification.
• Statistical analysis included logistic regression, Kaplan-Meier, Cox models, and competing risk analysis for local recurrence.

Main Results:

• A significant decrease in penile amputation rates over the study period.
• Higher 5-year cumulative incidence of local recurrence in penile preservation (27%) versus partial penectomy (3.8%).
• No significant difference in 5-year CSS between penile preservation and amputation groups after adjusting for covariates. Pathological T stage, N stage, and lymphovascular invasion were significant survival factors.

Conclusions:

• Increasing utilization of penile preservation therapies for PSCC in recent years.
• Penile preservation is associated with higher local recurrence rates but does not compromise 5-year cancer-specific survival.
• Management of PSCC can safely incorporate penile sparing techniques.