Organ Preservation Surgery for Carcinoma Penis

Yuvaraja, T.; Waigankar, S.; Dharmadhikari, N.; Pednekar, A.

doi:10.1007/s13193-016-0573-6

Cited by 4 publications

(4 citation statements)

References 48 publications

(64 reference statements)

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“…Wide local excision involves removing the tumor tissue along with unaffected tissue around it and is indicated for Tis, Ta and T1 with little or no invasion. Traditionally, a 10 mm clearance area of unaffected tissue was excised in cases of low grade tumors (grade 1-2), and 15 mm clearance area for higher grade tumors (grade 2 and above) ( 44 , 49 ). However, research also suggests that smaller excision margins can be successfully used and is determined by the grade of the tumor ( 21 , 50 ) glans resurfacing (removal of glans epithelium) may be also be considered in some cases ( 21 , 44 ).…”

Section: Review and Discussionmentioning

confidence: 99%

“…However, research also suggests that smaller excision margins can be successfully used and is determined by the grade of the tumor ( 21 , 50 ) glans resurfacing (removal of glans epithelium) may be also be considered in some cases ( 21 , 44 ). Wide local excision is not performed in cases where the tumor is close to the urethra, where the tumor involves the meatus, or when the tumor extends more than 50% of the glans penis ( 49 ). Partial or complete glansectomy can be used for Tis, T or T1 tumors that involve only the glans and/or prepuce but are not indicated for G1-2 T1 tumors ( 44 ).…”

Section: Review and Discussionmentioning

confidence: 99%

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A comprehensive review of current knowledge on penile squamous cell carcinoma

Thumma,

Pitla,

Gorantla

et al. 2024

Front. Oncol.

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Neoplasm of the penis is relatively rare in most regions representing 0-2% of cancers worldwide. While the penis can be affected by sarcomas, basal cell carcinomas or even melanoma, Penile Squamous Cell Carcinoma (PSCC) represents approximately 95% of all penile neoplasms. Despite its rarity and most common presentation at later decades of life most individuals diagnosed with PSCC are faced with significant decrease in quality of life. The prevalence and incidence vary among different regions and populations, but a common trend is for diagnosis to occur late (stage 4). Underdeveloped countries are traditionally reported to have higher incidence rates; however, rates may vary significantly between urban and rural areas even in developed countries. Age adjusted rates are on the rise in some countries that used to have incidence rates of 1:100 000 or less. The list of associated risk factors is long and includes among others, lack of neonatal circumcision, poor genital hygiene, socioeconomic status, history of human papillomavirus (HPV) infection and penile intraepithelial neoplasia (PeIN). Many risk factors are widely debated among experts however HPV and PeIN are indisputable risk factors, and both also form part of the classification system for PSCC. Both conditions may have occurred in the past or be present at the time of diagnosis and identifying them plays a major role in management strategies. For such a rare condition PSCC can present in many different forms clinically making diagnosis no easy feat. Diagnosis of PSCC is done through clinical examination, including lymph node palpation, followed by a biopsy, which is essential for the classification. Lymph node involvement is a common finding at first presentation and investigation of spread to deep nodes is important and can be done with the aid of PET-CT. Treatment options for PSCC include surgery, chemotherapy, and radiation therapy. Surgical removal of the tumor is considered the most effective however can lead to severe decrease of quality of life. Chemotherapy is used in the case of fixed or bulky lymph nodes, where surgery is not indicated, and for distant metastasis. Radiation therapy is particularly effective in the case of HPV-positive PSCC.

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Section: Review and Discussionmentioning

confidence: 99%

Section: Review and Discussionmentioning

confidence: 99%

A comprehensive review of current knowledge on penile squamous cell carcinoma

Thumma,

Pitla,

Gorantla

et al. 2024

Front. Oncol.

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“…Conversely, the depth of invasion in later presentations of disease make organ sparing procedures often an impossibility, necessitating surgical resection via partial or radical penectomy. [11][12][13][14] Individuals who received treatment via conservative management have consistently reported greater preservation of sexual functions as well as better overall quality of life (QoL) when compared to surgical cases. 11 The exclusive applicability of these organ sparing therapies in early-stage presentations of disease stresses the importance of mandatory initial evaluation of the patient by way of physical examination, especially during and following the rise of telemedicine during the COVID-19 era.…”

Section: Introductionmentioning

confidence: 99%

A quality assurance review of penile cancer diagnostic delays and stage at presentation during the COVID-19 pandemic

Janes

Henley²,

Andrews³

et al. 2023

CUAJ

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Introduction: Penile carcinomas represent a rare malignancy associated with significant psychosocial impacts that deter afflicted individuals from seeking medical attention, thus, worsening prognosis. Following the dramatic shift in healthcare delivery to virtual platforms, it is suspected that prevalent psychosocial impacts have been further compounded by the COVID-19 pandemic, resulting in several late-stage presentations and engendering poorer outcomes. Methods: A retrospective chart review of surgically managed cases of penile cancer was conducted from January 2019 to June 2022 to identify patients that may have been unduly impacted by the COVID-19 pandemic. Included cases were analyzed in quantifying diagnostic and treatment delays, along with patient outcomes. Relevant epidemiological and pathological markers were also examined. Results: Ten patients met the inclusion criteria. Average time delay from first complaint of a penile lesion to surgical management was 75 days, with 60% of patients experiencing a time delay of two months or more. The average delay from first complaint to diagnosis was 62 days in 2020 and 18 days in 2021. Advanced-stage disease was present in n=6 (60%) of individuals at presentation, while n=4 (40%) of patients perished during the study period. Conclusions: In cases of concern for penile malignancy, virtual care cannot replace the necessity of physical exams in preventing diagnostic and treatment delays. The present study further highlights the necessity of initial physical examination of penile abnormalities in preventing fatal outcomes for those afflicted. Such consideration warrants urgent examination of referred males with genital abnormalities to prevent further exacerbation of delays.

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“…These concerns commonly make them reluctant to undergo mutilating treatment that will affect their body image and self-confidence. This scenario led urologists to develop surgical therapeutic options that are capable of addressing both physical and psychological issues of these patients, ultimately resulting in a major shift in paradigm from "mutilation" to "preservation" [5][6][7]. Therefore, contemporary penile preservation in the surgical management of penile cancer has assumed a leading position, with the simultaneous objective of achieving good oncological control with the least impact on anatomy, function, and psychosexual health of the patient [8].…”

Section: Introductionmentioning

confidence: 99%

New Perspectives in Penile Cancer Management: How to Retain Functional Outcomes

Martins

2023

MRAJ

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Penile cancer is a rare malignancy and a debilitating condition in most industrialized nations that often requires aggressive surgical or multimodal treatment with significant anatomical, functional, and psychosocial impact on patients’ quality of life. Total or partial penile amputation has been considered the standard of treatment according to locoregional clinical staging and risk stratification. However, these surgical options are associated with significant negative functional and psychological outcomes in terms of body image, self-esteem, and manhood resulting in loss of sexual function and inability of upright voiding. Recently, a critical paradigm shift has taken place in the clinical management of penile malignancy, that is, the implementation of alternative, less-invasive surgical strategies to deal with the primary malignancy. These sparing approaches of penile anatomy aim to retain penile and urinary functions and overall quality of life and thus interfering as little as possible with functional anatomy. This paradigm shift has been made possible by advances in surgical and technological developments which have resulted in organ-preserving strategies with gratifying psychosocial and functional outcomes simultaneously without compromising final cancer control. This spectrum of novel surgical strategies includes local excision, glansectomy, and partial penectomy followed by surgical reconstructive procedures consisting of primary closure of the resulting defect, closure with skin flaps or split- thickness skin grafts, penile lengthening and/or enhancing procedures, neophalloplasty, and, more recently, penile transplantation fostered by limitations of conventional reconstruction. This review discusses the complexities of surgical reconstruction following penile cancer treatment including the burgeoning field of penile transplantation.

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Organ Preservation Surgery for Carcinoma Penis

Cited by 4 publications

References 48 publications

A comprehensive review of current knowledge on penile squamous cell carcinoma

A comprehensive review of current knowledge on penile squamous cell carcinoma

A quality assurance review of penile cancer diagnostic delays and stage at presentation during the COVID-19 pandemic

New Perspectives in Penile Cancer Management: How to Retain Functional Outcomes

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