Management of advanced squamous cell carcinoma of the penis

In some parts of the world, SCC of the penis represents a significant health problem. Although in the early stages it can be cured by surgery, it is often advanced at the time of presentation and many patients refuse surgery. Once the lymph nodes are involved with tumor, the prognosis is poor, with a 5-year survival of 10% to 30%. Because of the high associated morbidity and mortality, effective means of treating this disorder must be developed. As shown by the studies outlined earlier in the article, SCC of the penis is responsive to many cytotoxic agents and is also a radiosensitive tumor. Some of the agents active in this disorder are outlined in Table 1. These agents include bleomycin, methotrexate, cisplatin, and 5-FU. Using the combined-modality approach with chemotherapy, radiation therapy, and surgery, many patients with advanced disease have achieved a clinical remission with long survivals. Further work with larger sample sizes and randomized comparisons between the available regimens need to be performed in order to determine the optimal therapy for this disease. In addition, studies with new agents and radiation and surgical techniques need to be performed so that we may continue to improve our rates of long-term remission from this disease.