[Penile cancer: diagnosis and staging]

Area of Science:

• Oncology
• Urology
• Surgical Pathology

Background:

• Penile cancer diagnosis often relies on visual inspection, but histologic confirmation is necessary before treatment.
• Clinical examination is vital for staging, assessing local invasion (cavernous bodies, urethra), and evaluating inguinal lymph nodes.
• Preoperative imaging is reserved for equivocal cases.

Purpose of the Study:

• To outline the diagnostic and treatment strategies for penile cancer.
• To emphasize the critical role of lymph node management in prognosis.
• To highlight the limitations of imaging in detecting micrometastatic lymph nodes.

Main Methods:

• Clinical examination for tumor staging and lymph node assessment.
• Histologic verification for definitive diagnosis.
• Invasive inguinal lymph node biopsy for staging from pT1G2.
• Surgical removal of the primary tumor and metastatic lymph nodes.

Main Results:

• Histologic verification is mandatory prior to penile cancer treatment.
• Lymph node status is the primary prognostic factor in penile cancer.
• Imaging techniques (ultrasound, CT, MRI, PET/CT) cannot reliably detect micrometastatic lymph nodes.
• Invasive lymph node diagnosis is recommended for penile cancer stages pT1G2 and higher.

Conclusions:

• Complete tumor removal and effective lymph node management are key to curative treatment for penile cancer.
• Early diagnosis through self-examination and regular physical check-ups, coupled with adequate treatment, can lead to over 90% cure rates.
• Invasive staging of inguinal lymph nodes is essential for accurate treatment planning and improved patient outcomes.