Skip to main content

Surgical Management of Advanced Penile Cancer

  • Chapter
  • First Online:
Penile Cancer – A Practical Guide

Part of the book series: Management of Urology ((MU))

  • 119 Accesses

Abstract

Penile squamous cell carcinoma is a rare cancer and can present as localized or locally advanced disease. The presence of metastatic lymph nodes remains the most important prognostic indicator. The surgical management is based on the extent of the primary tumour, pathological parameters of the primary lesion and reginal lymph node status. Most patients with advanced penile cancer benefit from a multimodal treatment approach combining chemotherapy with surgical treatment. Extensive metastatic cases which are confined to the inguinal regions present a therapeutic challenge due to the presence of extranodal disease with involvement of adjacent tissues. In those with such advanced disease, palliative surgical treatment may be an option for patients with a good performance status, as the prognosis in these cases is very poor.

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

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Djajadiningrat RS, Graafland NM, van Werkhoven E, Meinhardt W, Bex A, van der Poel HG, et al. Contemporary management of regional nodes in penile cancer-improvement of survival? J Urol. 2014;191(1):68–73.

    Article  PubMed  Google Scholar 

  2. Solsona E, Iborra I, Ricos JV, Monros JL, Dumont R, Casanova J, et al. Corpus cavernosum invasion and tumor grade in the prediction of lymph node condition in penile carcinoma. Eur Urol. 1992;22(2):115–8.

    Article  CAS  PubMed  Google Scholar 

  3. Ficarra V, Akduman B, Bouchot O, Palou J, Tobias-Machado M. Prognostic factors in penile cancer. Urology. 2010;76(2 Suppl 1):S66-73.

    PubMed  Google Scholar 

  4. Velazquez EF, Ayala G, Liu H, Chaux A, Zanotti M, Torres J, et al. Histologic grade and perineural invasion are more important than tumor thickness as predictor of nodal metastasis in penile squamous cell carcinoma invading 5 to 10 mm. Am J Surg Pathol. 2008;32(7):974–9.

    Article  PubMed  Google Scholar 

  5. Minhas S, Kayes O, Hegarty P, Kumar P, Freeman A, Ralph D. What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJU Int. 2005;96(7):1040–3.

    Article  PubMed  Google Scholar 

  6. Kranz J, Parnham A, Albersen M, Sahdev V, Ziada M, Nigam R, et al. Urethral centralization and pseudo-glans formation after partial penectomy. Urologe A. 2017;56(10):1293–7.

    Article  CAS  PubMed  Google Scholar 

  7. de Vries HM, Chipollini J, Slongo J, Boyd F, Korkes F, Albersen M, et al. Outcomes of perineal urethrostomy for penile cancer: a 20-year international multicenter experience. Urol Oncol. 2021;39(8):500. e9- e13

    Article  Google Scholar 

  8. Hakenberg OW, Comperat EM, Minhas S, Necchi A, Protzel C, Watkin N. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015;67(1):142–50.

    Article  PubMed  Google Scholar 

  9. Clark PE, Spiess PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE, et al. Penile cancer: clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2013;11(5):594–615.

    Article  CAS  Google Scholar 

  10. Pagliaro LC, Williams DL, Daliani D, Williams MB, Osai W, Kincaid M, et al. Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol. 2010;28(24):3851–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Shukla CJ, Shabbir M, Feneley MR, Withey S, Muneer A, Minhas S. Palliation of male genital cancers. Clin Oncol (R Coll Radiol). 2010;22(9):747–54.

    Article  CAS  PubMed  Google Scholar 

  12. Ottenhof SR, Leone A, Djajadiningrat RS, Azizi M, Zargar K, Kidd LC, et al. Surgical and oncological outcomes in patients after vascularised flap reconstruction for locoregionally advanced penile cancer. Eur Urol Focus. 2019;5(5):867–74.

    Article  PubMed  Google Scholar 

  13. Koifman L, Hampl D, Ginsberg M, Castro RB, Koifman N, Ornellas P, et al. The role of primary inguinal surgical debulking for locally advanced penile cancer followed by reconstruction with myocutaneous flap. Int Braz J Urol. 2021;47(6):1162–75.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Alnajjar HM, MacAskill F, Christodoulidou M, Mosahebi A, Akers C, Nigam R, et al. Long-term outcomes for penile cancer patients presenting with advanced N3 disease requiring a myocutaneous flap reconstruction or primary closure-a retrospective single Centre study. Transl Androl Urol. 2019;8(Suppl 1):S13–21.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhu Y, Zhang SL, Ye DW, Yao XD, Dai B, Zhang HL, et al. Prospectively packaged ilioinguinal lymphadenectomy for penile cancer: the disseminative pattern of lymph node metastasis. J Urol. 2009;181(5):2103–8.

    Article  PubMed  Google Scholar 

  16. Graafland NM, van Boven HH, van Werkhoven E, Moonen LM, Horenblas S. Prognostic significance of extranodal extension in patients with pathological node positive penile carcinoma. J Urol. 2010;184(4):1347–53.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yao Zhu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Zhu, Y., Ye, D., Gu, W. (2023). Surgical Management of Advanced Penile Cancer. In: Brunckhorst, O., Ahmed, K., Muneer, A., Alnajjar, H.M. (eds) Penile Cancer – A Practical Guide. Management of Urology. Springer, Cham. https://doi.org/10.1007/978-3-031-32681-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-32681-3_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-32680-6

  • Online ISBN: 978-3-031-32681-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics