Multi-Institutional Long-Term Experience With Conservative Surgery for Invasive Penile Carcinoma

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2003Multi-Institutional Long-Term Experience With Conservative Surgery for Invasive Penile Carcinoma NABIL K. BISSADA, HOSSAM H. YAKOUT, WAHIB E. FAHMY, MAGED S.T. GAYED, A. KARIM TOUIJER, GRAHAM F. GREENE, and KAMAL A. HANASH NABIL K. BISSADANABIL K. BISSADA , HOSSAM H. YAKOUTHOSSAM H. YAKOUT , WAHIB E. FAHMYWAHIB E. FAHMY , MAGED S.T. GAYEDMAGED S.T. GAYED , A. KARIM TOUIJERA. KARIM TOUIJER , GRAHAM F. GREENEGRAHAM F. GREENE , and KAMAL A. HANASHKAMAL A. HANASH View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)63942-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Invasive squamous cell carcinoma of the penis occurs on the glans, prepuce, glans and prepuce, coronal sulcus and shaft. Penile squamous cell carcinoma subsequently invades local structures, corpora cavernosa and the urethra, and metastasizes to the inguinal lymph nodes. Invasive squamous cell carcinoma of the penis usually requires total or partial penectomy. We studied the effect of primary tumor resections tailored to the anatomical extent of the cancer with preservation of uninvolved structures in select patients with invasive penile squamous cell carcinoma. Materials and Methods: A total of 30 patients between 39 and 82 years old were treated with unconventional conservative surgical excision of the primary penile lesion. More than 130 patients were excluded from the study because they were treated with partial or total penectomy, Mohs’ surgery or more extensive surgery. The 30 patients underwent preoperative biopsy with careful mapping of the extent of the disease. Patient age, tumor extent and grade, operative details, outcome and length of followup were analyzed. Results: Tumor size ranged from 1.5 to 8 cm. in diameter. Tumors were well differentiated in 19 patients, moderately differentiated in 5 and poorly differentiated in 6. A total of 17 patients underwent ilioinguinal lymphadenectomy, 12 of whom had pathologically positive lymph nodes. Inguinal radiation was used in 2 patients. Chemotherapy was given to 7 patients with extensive inguinal lymphadenopathy and to 2 of 5 with pathologically positive lymph nodes. Followup ranged from 12 to 360 months. A total of 21 patients had no evidence of disease at last followup. Tumor resection with no sacrifice of function was performed in 2 patients in whom 3 small recurrences developed. One patient with numerous tumors had 2 small recurrences, which were completely excised with no further recurrence. Of the 7 patients with advanced lymphadenopathy 5 and of 5 patients with pathologically positive lymph nodes at presentation 1 died of the cancer but had no local recurrence in the penis. Conclusions: In a minority of patients with anatomically suitable penile cancer conservative surgical techniques are safe and provide equal tumor control compared to conventional resections. The anatomical situation and tumor characteristics should dictate the choice of treatment for the primary penile lesion. Inguinal lymph nodes should be managed by appropriately established guidelines but should not influence the extent of primary penile lesion resection. References 1 : Partial and total penectomy for cancer. Urol Clin North Am1991; 18: 161. Google Scholar 2 : Penile cancer. Clinical presentation, diagnosis and staging. Urol Clin North Am1992; 19: 247. Google Scholar 3 : Tumors of the penis. In: . Philadelphia: W. B. Saunders Co.1992. chapt. 31. Google Scholar 4 : Benign and malignant lesion of the penis. In: Adult and Pediatric Urology. Edited by . St. Louis: Mosby1991: 1643. Google Scholar 5 : Conservative extirpative treatment of cancer penis. Urol Clin North Am1992; 19: 283. 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Abstract, Google Scholar From the Departments of Urology, Medical University of South Carolina, Hollings Cancer Center, Charleston, South Carolina, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia, and Arkansas Cancer Research Center, Little Rock, Arkansas© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKamel M, Bissada N, Warford R, Farias J and Davis R (2018) Organ Sparing Surgery for Penile Cancer: A Systematic ReviewJournal of Urology, VOL. 198, NO. 4, (770-779), Online publication date: 1-Oct-2017.Philippou P, Shabbir M, Malone P, Nigam R, Muneer A, Ralph D and Minhas S (2018) Conservative Surgery for Squamous Cell Carcinoma of the Penis: Resection Margins and Long-Term Oncological ControlJournal of Urology, VOL. 188, NO. 3, (803-808), Online publication date: 1-Sep-2012.Feldman A and McDougal W (2018) Long-Term Outcome of Excisional Organ Sparing Surgery for Carcinoma of the PenisJournal of Urology, VOL. 186, NO. 4, (1303-1307), Online publication date: 1-Oct-2011.Gulino G, Sasso F, Falabella R and Bassi P (2018) Distal Urethral Reconstruction of the Glans for Penile Carcinoma: Results of a Novel Technique at 1-Year of FollowupJournal of Urology, VOL. 178, NO. 3, (941-944), Online publication date: 1-Sep-2007.Shindel A, Mann M, Lev R, Sengelmann R, Petersen J, Hruza G and Brandes S (2018) Mohs Micrographic Surgery for Penile Cancer: Management and Long-Term FollowupJournal of Urology, VOL. 178, NO. 5, (1980-1985), Online publication date: 1-Nov-2007.Evans C (2018) Editorial CommentJournal of Urology, VOL. 176, NO. 2, (580-580), Online publication date: 1-Aug-2006.Bissada N and Greene G (2018) Re: Phallic Preserving Surgery in Patients With Invasive Squamous Cell Carcinoma of the PenisJournal of Urology, VOL. 176, NO. 4, (1687-1688), Online publication date: 1-Oct-2006.TABATABAEI S, HARISINGHANI M and McDOUGAL W (2018) REGIONAL LYMPH NODE STAGING USING LYMPHOTROPIC NANOPARTICLE ENHANCED MAGNETIC RESONANCE IMAGING WITH FERUMOXTRAN-10 IN PATIENTS WITH PENILE CANCERJournal of Urology, VOL. 174, NO. 3, (923-927), Online publication date: 1-Sep-2005. Volume 169Issue 2February 2003Page: 500-502 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordscarcinoma, squamous celllymphatic diseasespenile neoplasms, Mohs surgeryMetricsAuthor Information NABIL K. BISSADA More articles by this author HOSSAM H. YAKOUT More articles by this author WAHIB E. FAHMY More articles by this author MAGED S.T. GAYED More articles by this author A. KARIM TOUIJER More articles by this author GRAHAM F. GREENE More articles by this author KAMAL A. HANASH More articles by this author Expand All Advertisement PDF downloadLoading ...