Skip to main content
SpringerLink
Log in

Current trends in the management of carcinoma penis – a review

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Aims and introduction: To review the currentliterature, recent advances and recenttrends in the management of squamous cellcarcinoma of the penis so as to have a broad overview of penile cancer and its currentmanagement. The review was considered keepingin mind that squamous penile carcinoma is aninfrequently encountered malignancy and thatthe etiology is still unclear though certainpredisposing conditions are known to exist andalso that controversy still exists as to theappropriate management of inguinal adenopathy.We also reviewed the etiological factors, clinicalpresentation, diagnosis, staging, prognostic factors in addition to management andprophylaxis.Methods: A literature search was carried outfrom Pubmed for indexed articles published over the last 50 years using the key words`Management penile carcinoma', `Squamous cellcarcinoma penis' and `inguinal lymphadenectomy'. Results: The search yielded over 1500 indexedpublished articles and reports. Important major reports and studies were reviewed,screened and tracked for recent changes andtrends in the management of penile cancer. These were analyzed, tabulated and discussed. Conclusions: Newer approaches to the management of penile cancer include use of laser, photodynamic therapy, neoadjuvanttherapy and sentinel node mapping by lympho-gamma-scintigraphy. The current approachtowards managing inguinal adenopathy shows an increasing trend towards the use of these newermodalities as well as the use of certain modifications in lympadenectomy such as (theuse of ligasure®, modified dissection, saphenous vein sparing and lymphoscintigraphy,etc.) thereby making the procedure considerably less morbid than before.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mobilio G, Ficarra V. Genital treatment of penile carcinoma. Curr Opin Urol 2001; 1(3): 299-304.

    Google Scholar 

  2. Schoeneich G, Perabo FG, Muller SC. Squamous cell carcinoma of the penis. Andrologia 1999; 31(Suppl 1): 17-20.

    Google Scholar 

  3. Chiu TY, Huang HS, Lai MK, Chen J. Penile cancer in Taiwan - 20 years' experience at National Taiwan University Hospital. J Formos Med Assoc 1998; 97(10): 673-678.

    Google Scholar 

  4. Kulkarni PV, Jaiswal SS, Rathod SB, Khalique A, Kulkarni RR. Profile of malignancies at Medical College, Ambajogai - (15 years retrospective study). Indian J Cancer 1996; 33(1): 31-36.

    Google Scholar 

  5. Nagpal BL, Prabhakar BR, Kataria SP, Kapoor K, Bal MS. Male genital tract tumors in Punjab, India. J Environ Pathol Toxicol Oncol 1992; 11(5-6): 331-334.

    Google Scholar 

  6. Connell CF, Berger NA. Management of advanced squamous cell carcinoma of the penis. Urol Clin North Am 1994; 21(4): 745-756.

    Google Scholar 

  7. Sanghvi LD. Cancer epidemiology: the Indian scene. J Cancer Res Clin Oncol 1981; 99: 1-14.

    Google Scholar 

  8. Soria JC, Theodore C, Gerbaulet A. Squamous cell carcinoma of the penis. Bull Cancer 1998; 85(9).

  9. Mikhail GR. Cancers, precancers, and pseudocancers on the male genitalia. A review of clinical appearances, histopathology, and management. J Dermatol Surg Oncol 1980; 6: 1027-1035.

    Google Scholar 

  10. Das S, Tunuguntla HS. Balanitis xerotica obliterans - a review. World J Urol 2000; 18: 382–387.

    Google Scholar 

  11. Puras A, Gonzalez-Flores B, Sotolong A. Staging lymphadenectomy in the treatment of carcinoma of the penis. Proc Kimbrough Urol Semin 1980; 12: 143.

    Google Scholar 

  12. Johnson DE, Fuerst DE, Ayala AG. Carcinoma of the penis: experience in 153 cases. Urology 1973; 1: 404.

    Google Scholar 

  13. Dewire D, Lepor H. Anatomic considerations of the penis and its lymphatic drainage. Urol Clin North Am 1992; 19: 211-219.

    Google Scholar 

  14. Rudd FV, Rott RK, Skoglund RW, Ansell JS. Tumor induced hypercalcemia. J Urol 1972; 107:986.

    Google Scholar 

  15. Agrawal A, Pai D, Ananthakrishnan N, Smile SR, Ratnakar C. Clinical and sonographic findings in carcinoma of the penis. J Clin Ultrasound 2000; 28: 399-406.

    Google Scholar 

  16. Soria JC, Theodore C, Gerbaulet A. Epidermoid carcinoma of the penis. Bull Cancer 1998; 85: 773-784.

    Google Scholar 

  17. Emerson RE, Ulbright TM, Eble IN, Geary WA. Predicting cancer progression in patients with penile squamous cell carcinoma: the importance of depth of invasion and vascular invasion. Mod Pathol 2001; 14: 963-968.

    Google Scholar 

  18. Slaton JW, Morgenstern N, Levy DA, Santos MW Jr. Tumor stage, vascular invasion and the percentage of poorly differentiated cancer: independent prognosticators for inguinal lymph node metastasis in penile squamous cancer. J Urol 2001; 165(4): 138-142.

    Google Scholar 

  19. Ficarra V, D'Amico A, CavalIeri S, Zanon G, Mofferdin A, Schiavone D, Malossini G, Mobilio G. Surgical treatment of penile carcinoma: our experience from 1976 to 1997. Urol Int 1999; 62: 234-237.

    Google Scholar 

  20. Kamat MR, Kulkarni JN, Tongaonkar HB. Carcinoma of the penis: the Indian experience. J Surg Oncol 1993; 52: 50-55.

    Google Scholar 

  21. Demkow T. The treatment of penile carcinoma: experience in 64 cases. Int Urol Nephrol 1999; 31: 525-531.

    Google Scholar 

  22. Ravi R. Correlation between the extent of nodal involvement and survival following groin dissection for carcinoma of the penis. Br J Urol 1993; 72: 817-819.

    Google Scholar 

  23. Derakhshani P, Neubauer S, Braun M, Bargmann H. Results and 10-year follow-up in patients with squamous cell carcinoma of the penis. Urol Int 1999; 62: 238-244.

    Google Scholar 

  24. Konnak JW. Conservative management of low-grade neoplasms of the male urethra: a preliminary report. J Urol 1980; 123: 175-175.

    Google Scholar 

  25. Jensen MS. Cancer of the penis in Denmark 1942 to 1962 (51 cases). Dan Med Bull 1977; 24:66.

    Google Scholar 

  26. McDougal WS, Kirchner FK Jr, Edwards RH, Killion LT. Treatment of carcinoma of the penis: the case of primary lymphadenectomy. J Urol 1986; 136: 38.

    Google Scholar 

  27. Sufrin G, Huben R. Benign and malignant lesions of the penis. In Gillenwater IY, ed. Adult and Pediatric Urology, 2nd ed. Chicago: Year Book Med Pub, 1991: 1643.

    Google Scholar 

  28. Moh's FE. Chemosurgery: a microscopically controlled method of cancer excision. Arch Surg 1941; 42:279.

  29. Mohs FE, Snow SN, Larson PO. Moh's micrographic surgery for penile tumors. Urol Clin North Am 1992; 19: 291-304.

    Google Scholar 

  30. Mohs FE, Snow SN, Messing EM, Kuglitsch ME.Microscopically controlled surgery in the treatment of carcinoma of the penis. J Urol 1985; 133: 961.

    Google Scholar 

  31. Duncan W, Jackson SM. The treatment of early cancer of the penis with megavoltage x-rays. Clin Radiol 1972; 23: 246.

    Google Scholar 

  32. Canada TR, McDonald JC, Kuo TY, Simpson LD, Freed BR, Laughlin JS. Fast neutron beams from the MSKCC cyclotron. Eur J Cancer 1974; 10: 259-260.

    Google Scholar 

  33. Grabstald H, Kelley CD. Radiation therapy of penile cancer. Urology 1980; 15: 575.

    Google Scholar 

  34. Sagerman RH, Yu WS, Chung CT, Puranik A. External beam irradiation of cancer of the penis. Radiology 1984; 152: 183.

    Google Scholar 

  35. Sandeman TF. Carcinoma penis. Australas Radiol 1990 Feb; 34: 12-16.

  36. Kiltie AE, Elwell C, Close HJ, Ash DV. Iridium-192 implantation for node-negative carcinoma of the penis: the Cookridge Hospital experience. Clin Oncol (R ColI Radiol) 2000; 12: 25-31.

    Google Scholar 

  37. Mahlmann B, Doehn C, Feyerabend T. Radiotherapy of penis carcinoma. Urologe A 2001; 40: 308-312.

    Google Scholar 

  38. Zouhair A, Coucke PA, Jeanneret W, Douglas P, Do HP. Radiation therapy alone or combined surgery and radiation therapy in squamous-cell carcinoma of the penis? Eur J Cancer 2001; 37(2): 198-203.

    Google Scholar 

  39. Edsmyr F, Andersson L, Esposti P. Combined bleomycin and radiation therapy in therapy of carcinoma of the penis. Cancer 1985; 56: 257.

    Google Scholar 

  40. Modig H, Duchek M, Sjodin JG. Carcinoma of the penis. Treatment by surgery or combined bleomycin and radiation therapy. Acta Oncol 1993; 32: 653-655.

    Google Scholar 

  41. Pizzocaro G, Piva L. Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 1988; 27: 823-824.

    Google Scholar 

  42. Bandieramonte G, Lepera P, Marchesini R. Laser microsurgery of superficial lesions of the penis. J Urol 1987; 138: 315.

    Google Scholar 

  43. Boon TA. Sapphire probe laser surgery for localized carcinoma of the penis. Eur J Surg Oncol 1988; 14: 193.

    Google Scholar 

  44. Von Eschenbach AC, Johnson DE, Wishkow KI. Results of laser therapy for carcinoma of the penis: organ preservation. Prog Clin Biol Res 1991; 370: 407-412.

    Google Scholar 

  45. Harth Y, Hirshovitz B. Topical photodynamic therapy in basal and squamous cell carcinoma and penile Bowen's disease with 20% aminolevulinic acid, and exposure to red light and infrared light. Harefuah 1998; 134: 602-605, 671, 672.

    Google Scholar 

  46. Kvarstein B, Fossa SD, Harvei S. Diagnosis and treatment of penile cancer. Tidsskr Nor Laegeforen 2002; 122: 1194-1197.

    Google Scholar 

  47. Ektrom T, Edsmyr F. Cancer of the penis: a clinical study of 229 cases. Acta Chir Scand 1958; 115: 25.

    Google Scholar 

  48. Puras A, Gonzalez-Flores B, Furtuno B. Treatment of carcinoma of the penis. Proc Kimbrough Urol Semin 1978; 12: 143.

    Google Scholar 

  49. Srinivas V, Morse MJ, Herr HW. Penile cancer: relation of extent of nodal metastasis to survival. J Urol 1987; 137: 880-882.

    Google Scholar 

  50. Horenblas S, Van TH, Delemarre JFM. Squamous cell carcinoma of the penis: III, Treatment of regional lymph node. J Urol 1993; 149: 492-497.

    Google Scholar 

  51. Ornellas AA, Correia AL, Marota A. Surgical treatment of invasive squamous cell carcinoma of the penis. J Urol 1994; 151: 1244-1249.

    Google Scholar 

  52. Pizzocaro G, Piva L, Nicolai N. Improved management of nodal metastasis of squamous cell carcinoma of the penis. J Urol 1995; 153: 246.

    Google Scholar 

  53. Carver BS, Mata JA, Venable DD, Eastham JA. Squamous cell carcinoma of the penis: a retrospective review of forty-five patients in northwest Louisiana. South Med J 2002; 95: 822-825.

    Google Scholar 

  54. Horenblas S. More accurate staging and avoid extensive lymph node dissection in the majority of patients with penile carcinoma. BJU Int 2001; 88: 473-483.

    Google Scholar 

  55. Ravi R, Shrivastava BR, Mallikarjuna VS. Inguinal pick in invasive penile carcinoma: can it stage node negative patients? Arch Esp Urol 1991; 44: 1123-1126.

    Google Scholar 

  56. Coblentz TR, Theodorescu D. Morbidity of modified prophylactic inguinal lymphadenectomy for squamous cell carcinoma of the penis. J Urol 2002; 168: 1386-1389.

    Google Scholar 

  57. Fraley EE, Zhang G, Manivel C. The role of inguinal lymphadenectomy and significance of histological differentiation in treatment of carcinoma of the penis. J Urol 1989; 142: 1478-1482.

    Google Scholar 

  58. Bernardo N, Scorticati C Jr, Holst P. Treatment of the regional lymph nodes in Squamous carcinoma of the penis. Arch Esp Urol 1996; 49: 813-818.

    Google Scholar 

  59. Cabanas R. An approach to the treatment of penile carcinoma. Cancer 1977; 39: 456.

    Google Scholar 

  60. Fossa SD, Hall KS, Johannessen MB. Carcinoma of the penis: experience at the Norwegian radium hospital 1974-1985. Eur Urol 1987; 13: 372.

    Google Scholar 

  61. Tanis PJ, Lont AP, Meinhardt W, Olmos RA, Nieweg OE, Horenblas S. Dynamic sentinel node biopsy for penile cancer: reliability of a staging technique. J Urol 2002; 168: 76-80.

    Google Scholar 

  62. Benejam Gual JM, Garcia-Miralles Gravalos R. Usefulness of the dynamic sentinel node technique in patients with penile carcinoma. Actas Urol Esp 2001; 25: 409-414.

    Google Scholar 

  63. Valdes Olmos RA, Tanis PJ, Hoefnagel CA. Penile lymphoscintigraphy for sentinel node identification. Eur J Nucl Med 2001: 28: 581-585.

    Google Scholar 

  64. Wawroschek F, Vogt H, Bachter D. First experience with gamma probe guided sentinel lymph node surgery in penile cancer. Urol Res 2000; 28: 246-249.

    Google Scholar 

  65. Pompeo AC, Mesquita JL, Junior WA. Staged inguinal lymphadenectomy for carcinoma of the penis: 13 year prospective study of 50 patients. J Urol 1995; 153: 246.

    Google Scholar 

  66. Puras-Baes A, Rivera HJ, Miranda G. Role of superficial inguinal lymphadenectomy in carcinoma of the penis. J Urol 1995; 153: 246.

    Google Scholar 

  67. Scappini P, Piscioli F, Pusiol T. Penile cancer: aspiration biopsy cytology for staging. Cancer 1986; 58: 1526-1533.

    Google Scholar 

  68. Pow-Sang MR, Benavente V. Cancer of the penis. Cancer Control 2002; 9: 305-314.

    Google Scholar 

  69. Gursel EO, Georgountzos C, Uson AC. Penile cancer. Urology 1973; 1: 569.

    Google Scholar 

  70. Leewansangtong S, Srinualnad S, Chaiyaprasithi B. The risks of lymph node metastasis and the prognostic factors in carcinoma of the penis: analysis of 50 patients treated with bilateral ilioinguinal lymphadenectomy. J Med Assoc Thai 2001; 84: 204-211.

    Google Scholar 

  71. Cruz Guerra NA, Allona Almagro A. Lymphadenectomy in squamous carcinoma of the penis: review of our series. Actas Urol Esp 2000; 24: 709-714.

    Google Scholar 

  72. Riveros M, Gorostiaga R. Cancer of the penis. Arch Surg 1962; 85: 377.

    Google Scholar 

  73. Lopes A, Bezerra AL, Serrano SV. Iliac nodal metastases from carcinoma of the penis treated surgically. BJU Int 2000; 86: 690-693.

    Google Scholar 

  74. Gallo Rolania FJ, Beneitez Alvarez ME, Izquierdo Garcia FM. The role of imguinal lymphadenectomy in epidermoid carcinoma of the penis. Use of Ligasure and analysis of the results. Arch Esp Urol 2002; 55: 535-538.

    Google Scholar 

  75. Ravizzini GC, Wagner M, Borges-Neto S. Positron emission tomography detection of metastatic penile squamous cell carcinoma. J Urol 2001; 165(5): 1633-1634.

    Google Scholar 

  76. Wilbert DM. Lymph node metastases in penis carcinoma. Therapeutic options and outcome. Urologe A 1999; 38: 332-336.

    Google Scholar 

  77. Schlag PM. The 'Sentinel Node' concept: more questions raised than answers provided? Oncologist 1998; 3: 6-7.

    Google Scholar 

  78. Senthil Kumar MP, Ananthakrishnan N. Predicting regional lymph node metastasis in carcinoma of the penis: a comparison between fine-needle aspiration cytology, sentinel lymph node biopsy and medial inguinal lymph node biopsy. BJU 1998; 81: 453-457.

    Google Scholar 

  79. Colberg JW, Andriole GL, Catalona WJ. Long-term follow-up of men undergoing modified inguinal lymphadenectomy for carcinoma of the penis. BJU 1997; 79: 54-57.

    Google Scholar 

  80. McDougal WS. Carcinoma of the penis. J Urol 1995; 134: 1364-1369.

    Google Scholar 

  81. Theodorescu D, Russo P, Zhang ZF. Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 1996; 155: 1626-1631.

    Google Scholar 

  82. DeKernion JB, Tynberry P, Persky L. Carcinoma of the penis. Cancer 1973; 32: 1256.

    Google Scholar 

  83. Pizzocaro G, Piva L, Nicolai N. Treatment of lymphatic metastasis of squamous cell carcinoma of the penis: experience at the National Tumor Institute of Milan. Arch Ital Urol Androl 1996; 68: 169-172.

    Google Scholar 

  84. Pizzocaro G, Piva L, Bandieramonte G, Tana S. Up-to-date management of carcinoma of the penis. Eur Urol 1997; 32: 5-15.

    Google Scholar 

  85. Bertoni F. Carcinoma of the penis: radiotherapy. Arch Ital Urol Androl 1996; 68: 173-176; discussion 177-182.

    Google Scholar 

  86. Rozan R, Albuisson E, Giraud B, Donnarieix D. Interstitial brachytherapy for penile carcinoma: a multicentric survey (259 patients). Radiother Oncol 1995; 36: 83-93.

    Google Scholar 

  87. Murrel DS, Williams JL. Radiotherapy in the treatment of carcinoma of the penis. BJU 1965; 37: 211.

    Google Scholar 

  88. Haas GP, Blumenstein BA. Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a Southwest Oncology Group study. J Urol 1999; 161: 1823-1825.

    Google Scholar 

  89. Doehn C, Feyerabend T. Radiochemotherapy of penis carcinoma. Urologe A 2001; 40: 313-314.

    Google Scholar 

  90. Saint F, Legeais D, Leroy X, Biserte J, Gosselin B, Mazeman E. Therapeutic management or epidermoid carcinoma or the penis: anatomoclinical discussiion and review of the literature. Prog Urol 2000; 10: 128-133.

    Google Scholar 

  91. Shammas FV, Ous S, Fossa SD. Cisplatin and 5-fluorouracil in advanced cancer of the penis. J Urol 1992; 147: 630-632.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University College of Medical Sciences (University of Delhi) & Guru Tegh Bahadur Hospital, Delhi-95, India

    Iqbal Singh

  2. Consultant Urologist, Reader, Dept of Surgery, UCMS & GTBH, F-14 NDSE-2, New Delhi-, 110049, India; Phone

    A. Khaitan

Authors
  1. Iqbal Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Khaitan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Iqbal Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, I., Khaitan, A. Current trends in the management of carcinoma penis – a review. Int Urol Nephrol 35, 215–225 (2003). https://doi.org/10.1023/B:UROL.0000020339.92722.33

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:UROL.0000020339.92722.33

Search

Navigation