Treatment of carcinoma in situ of the glans penis with topical chemotherapy agents.

Abstract

e15100 Background: To establish the response rate of 5-flurouracil (5-FU) and imiquimod (IQ) in the treatment of penile CIS in a large contemporary series in a supra-network center. The use of topical agents in the treatment of CIS of the penis has been well described in the literature. Previous studies have been limited by small sample size and imprecise end-points. Methods: Retrospective review of all primary and recurrent cases of penile CIS treated with 5-FU and IQ identified from a prospective database over a 10- year period. Therapy was standardised in all cases with application to the lesion for 12 hours every 48 hours for 28 days. 5-FU was the first line therapy and IQ used as second line topical agent. The primary end-point was defined as complete response (CR = resolution of lesion), partial response (PR = lesion reduced in size and or visibility) or no response (NR = no improvement in lesion size and or visibility). The secondary end-points included local toxicity and adverse events. Results: A total of 86 patients were diagnosed with CIS of the penis over the 10-year period. 44/86 (51%) received topical chemotherapy. Mean follow-up was 34 months. The response rates, local toxicity and adverse events were analysed. The overall complete response rate for topical agents was 57% (Table). Conclusions: Topical chemotherapy agents are moderately effective first line therapy in the treatment of penile CIS. Toxicity and adverse events were low with our treatment protocol. The issue of long-term surveillance and assessment of partial responders remains a challenge. Topical chemotherapy should remain a first line treatment option for penile CIS. [Table: see text]

The treatment of penile carcinoma in situ (CIS) within a UK supra‐regional network

“…The largest previous study which reported on 44 patients treated with topical 5‐FU as first‐line treatment showed a complete response rate of 57% , which is less than in our present study. These authors describe application of 5‐FU to the lesion for 12 h every 48 h over 28 days.…”

Adherence to the EAU guidelines on Penile Cancer Treatment: European, multicentre, retrospective study

“…Treatment of the primary tumour and the decision to proceed to inguinal lymph node dissection were established according to local protocols based on the 2009 EAU guidelines. For patients with penile carcinoma in situ (CIS), the European Association of Urology recommends topical chemotherapy with 5% fluorouracil and imiquimod (Alnajjar et al 2012). For Ta/T1 lesions, laser ablation is a valid treatment (Colecchia et al 2009).…”

Penile cancer: a Brazilian consensus statement for low- and middle-income countries

“…The best conservative treatment of primary penile carcinoma in situ (Tis) is topical therapy (recommendation, LE: 2b). The use of topical 5-fluorouracil (5-FU) or imiquimod can provide from 40.0% to 73.7% complete response (Alnajjar et al 2012;Lucky et al 2015), with circumcision performed before therapy (Lucky et al 2015). Patients presenting with non-invasive localized SCC (Ta) should be treated by partial glansectomy and resurfacing (recommendation, LE: 4).…”