Advanced penile cancer

Abstract

Penile cancer is an uncommon disease in the industrialized world that most frequently presents at low stage and is cured with treatment of local and regional surgery. In cases of advanced cancer, the use of more aggressive surgical techniques and the addition of adjuvant therapy may be warranted. So far, few agents have been found that improve survival with metastatic disease and thus aggressive primary treatment is required. This review discusses diagnosis, staging, and therapy for high risk penile cancer.

Surgical treatment of advanced penile cancer

“…While data are scant, existing evidence shows the efficacy of chemotherapy for this disease. Administration of chemotherapy in addition to surgery or radiotherapy may increase patient survival (Heinlen et al 2012 ). However, no consensus has been reached as to the significant efficacy of chemotherapy or multimodality therapy for advanced penile carcinoma or metastatic PC.…”

“…In 2012, 1570 new cases and 370 deaths were documented in America (Siegel et al 2012 ; Barnholtz-Sloan et al 2007 ). In less developed nations, the condition is even worse, such as in sub-Saharan Africa and parts of South America, where it accounts for around 10% of all male malignancies (Heinlen et al 2012 ).…”

“…The focus of this article is advanced penile cancer which can be defined as bulky lymph node metastases (cN2 or cN3), failed primary lymphadenectomy leading progression to nodal metastases, matted or bulky lymphadenopathy (cN3), 2 metastatic superficial and deep inguinal lymph nodes (pN2), metastatic pelvic lymph node (N3), local erosion to pubic bone, abdominal wall, or pelvis (T4), and distant metastases (M1) (Heinlen et al 2012 ).…”

“…The current therapies for advanced penile carcinoma include surgical therapy, radiotherapy, chemotherapy, or multimodality therapy (Heinlen et al 2012 ). The prognosis in advanced penile carcinoma is poor, especially in patients with more than 2 inguinal lymph node metastases.…”

Clinical Manifestations of the Human Papillomavirus

“…They usually metastasize via the lymphatic system, first at the inguinal-femoral level, then at the pelvis; finally, they migrate to distant areas. The hematogenous spread can affect the lungs, liver, brain, pleura, bone, skin and other organs [63].…”