Cancer of the Penis: Clinical Features and Therapeutic Modalities in Senegalese Hospitals

Abstract

Background: Penile cancer is a rare malignancy in Senegal. This rarity is probably related to the fact that circumcision, which has a protective effect, is a common practice in childhood. Some of the known risk factors include uncircumcised status, chronic inflammatory conditions, and a history of condyloma acuminata, smoking, and possibly human papillomavirus exposure. It is a pathology in adults with a maximum incidence after the age of 50. In our practice penile cancer is most often diagnosed at an advanced stage or only a radical and mutilating treatment may be proposed. Aims: To describe the clinical and therapeutic features of penis cancer in Senegal. Patients and methods: we carried out a retrospective, descriptive, bicentric study, collecting the records of patients with penis cancer in the Urology-Andrology department of the Aristide Le Dantec University hospital and the military hospital of Ouakam between January 2010 and December 2019. Results: fourteen cases of penile cancer were diagnosed. The mean age was 53.2 years with extremes of 29 and 84 years, the average consultation time was 21 months. All patients were circumcised in childhood. The tumor was limited to the glans in 2 cases and involved the entire penis in 5 cases. Six patients had bilateral inguinal adenopathies. The histological type was squamous cell carcinoma in all cases with a predominance of grade 2 (8 cases). Patients were classified as cT3 (7 cases), cT2 (5 cases), cT4 (1 case) and cT1 (1 case). Treatment consisted of partial amputation of the penis (5 cases), emasculation and perineal urethrostomy (4 cases) total amputation and perineal urethrostomy (2 cases). Three patients had refused total penis amputation. The average length of follow-up was 26 months (4 and 72 months), 3 lymph nodes recurrences and 2 local recurrences were observed. Two patients died among the operated patients. Conclusion: Cancer of the penis is rare in Senegal. The delay in diagnosis explains the frequency of advanced forms which can only be treated by radical surgery.