Outcome of Glansectomy and Skin Grafting in the Management of Penile Cancer

Abstract

Purpose. To report outcome data for patients with penile cancer treated surgically with glansectomy and skin grafting. Materials and Methods. We retrospectively reviewed data on all patients undergoing surgical management of penile cancer by a single surgeon between 1998 and 2008. Outcomes in patients who underwent glansectomy and skin grafting were analysed. Results. Between 1998 and 2008 a total of 25 patients with a mean age 60 (39–83) underwent glansectomy and skin grafting. Six patients had carcinoma in situ (CIS); the stage in the remaining patients ranged from T1G1 to T3G3. Mean followup for patients was 28 months (range 6–66). Disease specific survival was 92% with 2 patients who had positive nodes at lymph node dissection developing groin recurrence. One patient developed a local recurrence requiring a partial penectomy. Conclusions. Penile preserving surgery with glansectomy and skin grafting is a successful technique with minimal complications for local control of penile carcinoma arising on the glans. Careful followup to exclude local recurrence is required.

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).…”

Organ-sparing reconstructive surgery in penile cancer: initial experiences at two Swedish referral centres

“…Although organ-preserving techniques convey a higher risk of local recurrence, most recurrences are surgically salvageable and overall mortality is comparable to that following primary amputation [13,[21][22][23][24]. Penile amputation should therefore be considered overtreatment in the vast majority of patients with penile cancer [2,13].…”

“…However, during the past two decades various less-mutilating techniques have been described and proposed for organ-preserving and reconstructive surgery in the treatment of penile cancer. The development of these techniques has reduced the negative impact on the functional and cosmetic outcomes associated with penectomy without jeopardizing long-term local oncological control [2][3][4][5][6][7][8].…”

Organ Preservation Surgery for Carcinoma Penis

“…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].…”

“…The disadvantages of this procedure include potential cancer recurrence in the remaining glans, risk of loss or contraction of graft, or graft overgrowth over the external urethral meatus, decreased penile sensitivity and a loss of penile length is a common complaint [32,35,36,38].…”