Organ‐preserving surgery for penile cancer: description of techniques and surgical outcomes

Abstract

• Penile-preserving surgery can achieve good penile cancer control with minimal morbidity and reduced psychosexual side-effects.

Surgical treatment of primary disease for penile squamous cell carcinoma: A Surveillance, Epidemiology, and End Results database analysis

“…The five-year cancer-specific survival rate following local recurrence was 92% in two large studies (1,6). In addition, sexual function, micturition and cosmetic results were generally well maintained following conservative surgery (3,(6)(7)(8)(20)(21)(22)(23). Accordingly, the use of PSS has risen dramatically at tertiary care centers and has been recommended by certain guidelines, including the European Association of Urology (EAU) Guidelines Group on Penile Cancer, as a standard surgical approach (11-13).…”

“…This change has been driven by an improved understanding of the biology of the disease (4), quality improvements in pathological evaluation and continuous refinements of surgical techniques (5). PSS has been previously reported to produce excellent cosmetic and functional results without sacrificing oncological outcomes in certain patients with early-stage penile tumors (3,(6)(7)(8)(9). Accordingly, an organ-sparing approach has been recommended for patients with stage T1 disease, according to the 2009 TNM clinical and pathological classification system (10), in national and international guidelines (11)(12)(13).…”

Organ Preservation Surgery for Carcinoma Penis

“…Brown C. T. et al in their study of five men with squamous cell carcinoma of glans penis performed subtotal resection of glans and showed that with preservation of distal urethra, spraying of urine observed with total glansectomy can be reduced. At a mean follow-up of 12 months, no recurrence was noted with good cosmetic and functional outcome [34].…”

“…Glansectomy can be done either partially or totally for dealing with local excision of distal tumors on the glans and prepuce (32)(33)(34)(35). This is followed by frozen sections from the cavernosal bed and urethral bed to confirm negative margins followed by an end-shaft urethrostomy.…”

“…Other techniques include glans reconstruction using full or slit-thickness grafting, lateral prepucial, or scrotal skin flap etc. [33][34][35][36]. C. T. Brown et al describes procedure of subtotal glans excision without grafting as a simple and cosmetically attractive alternative to other forms of conservative surgery for penile carcinoma [33].…”