Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review

Curr Opin Urol. 2023 Sep 1;33(5):383-389. doi: 10.1097/MOU.0000000000001109. Epub 2023 Jun 28.

Abstract

Purpose of review: Penile cancer (PeCa) is an orphan disease due to its rare incidence in high-income countries. Traditional surgical options for clinical T1-2 disease, including partial and total penectomy, can dramatically affect patient's quality of life and mental health status. In selected patients, organ-sparing surgery (OSS) has the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of various OSSs currently available for men diagnosed with PeCa seeking an organ-preserving option.

Recent findings: Patient survival largely depends on spotting and treating lymph node metastasis at an early stage. The required surgical and radiotherapy skill sets cannot be expected to be available in all centers. Consequently, patients should be referred to high-volume centers to receive the best available treatments for PeCa.

Summary: OSS should be used for small and localized PeCa (T1-T2) as an alternative to partial penectomy to preserve patient's quality of life while maintaining sexual and urinary function and penile aesthetics. Overall, there are different techniques that can be used with different response and recurrence rates. In case of tumor recurrence, partial penectomy or radical penectomy is feasible, without impacting overall survival.

Publication types

  • Review

MeSH terms

  • Humans
  • Male
  • Penile Neoplasms* / pathology
  • Penile Neoplasms* / surgery
  • Penis / surgery
  • Quality of Life
  • Sexual Behavior
  • Urologic Surgical Procedures, Male / adverse effects
  • Urologic Surgical Procedures, Male / methods