Advertisement

Annals of Surgical Oncology

, Volume 14, Issue 12, pp 3614–3619 | Cite as

Partial Penectomy for Patients With Squamous Cell Carcinoma of the Penis: The Memorial Sloan-Kettering Experience

  • Ruslan Korets
  • Theresa M. Koppie
  • Mark E. Snyder
  • Paul Russo
Urologic Oncology Original Papers

Abstract

Background

To present our institution’s experience with squamous cell carcinoma (SCC) of the penis, with analysis of oncologic efficacy and survival.

Methods

Between 1989 and 2005, we identified 32 consecutive patients (median age, 61 years) with SCC of the penis managed with partial penectomy. Clinicopathologic variables were examined, and overall and disease-specific survival were determined.

Results

Pathologic stage of the primary tumor was pTis in 1 patient (3%), pT1 in 11 (34%), pT2 in 16 (50%), and pT3 in 4 (13%). Pathologic grade was well differentiated in 9 patients (28%), moderately differentiated in 20 (63%), and poorly differentiated in 2 (6%). Twenty-five patients (78%) underwent inguinal lymph node dissection, with 15 (60%) demonstrating nodal metastases. Twenty-two patients (69%) underwent pelvic lymph node dissection; 21 were negative for pelvic nodal metastases, and 1 had grossly positive nodes. One patient developed local recurrence. After a mean follow-up of 34 months, overall survival was 56%. Numbers of patients alive and disease-free were 9 and 11 in the low-stage and advanced-stage groups, and 8 and 12 in the well and moderately differentiated groups, respectively. Both patients with poorly differentiated disease died of disease within 12 months from presentation.

Conclusions

Partial penectomy for SCC of the penis provides excellent local control, with low recurrence rate, and acceptable maintenance of urinary and sexual function. Outcomes are generally poor, however, for patients with regional metastases, even in moderately differentiated disease. Future studies are needed to identify a reliable method of predicting regional metastases.

Keywords

Penile neoplasms Carcinoma, squamous cell Urologic surgical procedures, male Lymph node excision 

Notes

Acknowledgment

Supported by AFUD/AUAER Research Scholar Program.

References

  1. 1.
    Jemal A, Siegel R, Ward E, et al. Cancer statistics 2006. CA Cancer J Clin 2006;56:106–30PubMedCrossRefGoogle Scholar
  2. 2.
    Narayana AS, Olney LE, Loening SA, et al. Carcinoma of the penis: analysis of 219 cases. Cancer 1982;49:2185–91PubMedCrossRefGoogle Scholar
  3. 3.
    McDougal WS. Advances in the treatment of carcinoma of the penis. Urology 2005;66:114–7PubMedCrossRefGoogle Scholar
  4. 4.
    McDougal WS. Phallic preserving surgery in patients with invasive squamous cell carcinoma of the penis. J Urol 2005;174:2218–20PubMedCrossRefGoogle Scholar
  5. 5.
    Pietrzak P, Corbishley C, Watkin N. Organ-sparing surgery for invasive penile cancer: early follow-up data. BJU Int 2004;94:1253–7PubMedCrossRefGoogle Scholar
  6. 6.
    Mazza ON, Cheliz GM. Glanuloplasty with scrotal flap for partial penectomy. J Urol 2001;166:887–9PubMedCrossRefGoogle Scholar
  7. 7.
    Davis JW, Schellhammer PF, Schlossberg SM. Conservative surgical therapy for penile and urethral carcinoma. Urology 1999;53:386–92PubMedCrossRefGoogle Scholar
  8. 8.
    Russo P, Horenblas S. Comprehensive Textbook of Genitourinary Oncology. 3rd ed. New York: Lippincott Williams & Wilkins, 2006Google Scholar
  9. 9.
    Russo P, Saldana EF, Yu S, Chaglasian T, et al. Myocutaneous flaps in genitourinary oncology. J Urol 1994;151:920–4PubMedGoogle Scholar
  10. 10.
    Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, et al. (eds) Penis. AJCC Cancer Staging Manual. New York: Springer 2002:303Google Scholar
  11. 11.
    Lont AP, Gallee MP, Meinhardt W, et al. Penis conserving treatment for T1 and T2 penile carcinoma: clinical implications of a local recurrence. J Urol 2006;176:575–80PubMedCrossRefGoogle Scholar
  12. 12.
    Hoffman MA, Renshaw AA, Loughlin KR. Squamous cell carcinoma of the penis and microscopic pathologic margins: how much margin is needed for local cure? Cancer 1999;85:1565–8PubMedCrossRefGoogle Scholar
  13. 13.
    Minhas S, Kayes O, Hegarty P, et al. What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJU Int 2005;96:1040–3PubMedCrossRefGoogle Scholar
  14. 14.
    Agrawal A, Pai D, Ananthakrishnan N, et al. The histological extent of the local spread of carcinoma of the penis and its therapeutic implications. BJU Int 2000;85:299–301PubMedCrossRefGoogle Scholar
  15. 15.
    McDougal WS, Kirchner FK Jr, Edwards RH, et al. Treatment of carcinoma of the penis: the case for primary lymphadenectomy. J Urol 1986;136:38–41PubMedGoogle Scholar
  16. 16.
    Ficarra V, D’Amico A, Cavalleri S, et al. Surgical treatment of penile carcinoma: our experience from 1976 to 1997. Urol Int 1999;62:234–7PubMedCrossRefGoogle Scholar
  17. 17.
    D’Ancona CA, Botega NJ, De Moraes C, et al. Quality of life after partial penectomy for penile carcinoma. Urology 1997;50:593–6PubMedCrossRefGoogle Scholar
  18. 18.
    Opjordsmoen S, Fossa SD. Quality of life in patients treated for penile cancer. A follow-up study. Br J Urol 1994;74:652–7PubMedGoogle Scholar
  19. 19.
    Romero FR, Romero KR, Mattos MA, et al. Sexual function after partial penectomy for penile cancer. Urology 2005;66:1292–5PubMedCrossRefGoogle Scholar
  20. 20.
    Theodorescu D, Russo P, Zhang ZF, et al. Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 1996;155:1626–31PubMedCrossRefGoogle Scholar
  21. 21.
    Bouchot O, Rigaud J, Maillet F, et al. Morbidity of inguinal lymphadenectomy for invasive penile carcinoma. Eur Urol 2004;45:761–5PubMedCrossRefGoogle Scholar
  22. 22.
    Kroon BK, Horenblas S, Meinhardt W, et al. Dynamic sentinel node biopsy in penile carcinoma: evaluation of 10 years experience. Eur Urol 2005;47:601–6PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Ruslan Korets
    • 1
  • Theresa M. Koppie
    • 1
  • Mark E. Snyder
    • 1
  • Paul Russo
    • 1
  1. 1.Department of SurgeryUrology Service, Memorial Sloan-Kettering Cancer CenterNew YorkUSA

Personalised recommendations