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World Journal of Urology

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01-04-2009 | Topic Paper

Penile preserving surgery and surgical strategies to maximize penile form and function in penile cancer: recommendations from the United Kingdom experience

Authors: Paul K. Hegarty, Majid Shabbir, Ben Hughes, Suks Minhas, Matthew Perry, Nicholas Watkin, David J. Ralph

Published in: World Journal of Urology | Issue 2/2009

Abstract

Objectives

The diagnosis of penile cancer can be devastating for a man and his partner. The fear of cancer is heightened by the prospect of penile amputation. While conventional radical surgery continues to be an effective approach to management, the emasculating nature of this treatment has serious psychological and sexual morbidity. Recent studies have challenged the traditional belief that a 2 cm margin was required for adequate oncological control.

Methods

We review the current options and status of such penile preserving techniques in the modern day management of penile cancer, and assess the use of the different techniques according to the stage and grade of disease based upon the combined experience of two superregional centres in the United Kingdom.

Results

A range of organ preserving procedures matches the clinical spectrum of patients presenting with penile cancer. These demonstrate excellent oncological control whilst maximizing penile function and form.

Conclusion

Innovative surgical techniques can now preserve as much penile tissue and functional integrity as possible, without compromising oncological control. This minimizes the impact of disease and its treatment on the quality of life of the patient.

Cancer trends in Engand and Wales (1950–1999) www.statistics.gov.uk. Date accessed 2004

Mistry T, Jones RW, Dannat E, Prasad KK, Stokdale AD (2007) A 10-year retrospective audit of penile cancer management in the UK. BJU Int 100:1277–1281. doi:10.1111/j.1464-410X.2007.07168.x PubMedCrossRef

National Institute for Clinical Excellence (2002) Guidance on cancer services. Improving outcomes in urological cancers—the manual. NICE, London, pp 83–85. http://www.nice.org.uk/pdf/Urological_Manual.pdf

Algaba F, Horenblas S, Piva GPL, Solsona E, Windahl T (2002) EAU guidelines on penile cancer. Eur Urol 42:201–214. doi:10.1016/S0302-2838(02)00308-1 CrossRef

Opjordsmoen S, Fossa SD (1994) Quality of life in patients treated for penile cancer. A follow-up study. Br J Urol 74(5):652–657PubMedCrossRef

McLean M, Akl AM, Warde P et al (1993) The results of primary radiation therapy in the management of squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys 25(4):623–628

Hoffman M, Renshaw A, Loughlin KR (1999) Squamous cell carcinoma of the penis and microscopic pathologic margins. How much margin is needed for local cure? Cancer 85(7):1565–1568. doi:10.1002/(SICI)1097-0142(19990401)85:<71565::AID-CNCR18>3.0.CO;2-0

Agrawal A, Pai D, Ananthakrishnan N et al (2000) The histological extent of the local spread of carcinoma of the penis and its therapeutic implications. BJUI 85(2):299–301. doi:10.1046/j.1464-410x.2000.00413.x CrossRef

Minhas S, Kayes O, Hegarty P et al (2005) What surgical resection margins are required to achieve oncological control in men with primary penile cancer? BJUI 96:1040–1043. doi:10.1111/j.1464-410X.2005.05769.x CrossRef

10.

Goette DK, Elgart M, DeVillez RL (1975) Erythroplasia of Queyrat. treatment with topically applied fluorouracil. JAMA 232(9):934–937

11.

Micali G, Nasca MR, Tedeschi A (2003) Topical treatment of intraepithelial penile carcinoma with imiquimod. Clin Exp Dermatol 28(Suppl 1):4–6. doi:10.1046/j.1365-2230.28.s1.2.x PubMedCrossRef

12.

van Bezooijen BP, Horenblas S, Meinhardt W, Newling DW (2001) Laser therapy for carcinoma in situ of the penis. J Urol 166(5):1670–1671. doi:10.1016/S0022-5347(05)65650-9 PubMedCrossRef

13.

Meijer RP, Boon TA, van Venrooij GE, Wijburg CJ (2007) Long-term follow-up after laser therapy for penile carcinoma. Urology 69(4):759–762. doi:10.1016/j.urology.2007.01.023 PubMedCrossRef

14.

Depasquale I, Park AJ, Bracka A (2000) The treatment of balanitis xerotica obliterans. BJUI 86(4):459–465. doi:10.1046/j.1464-410X.2000.00772.x CrossRef

15.

Hadway P, Corbishley CM, Watkin NA (2006) Total glans resurfacing for premalignant lesions of the penis: initial outcome data. BJUI 98(3):532–536. doi:10.1111/j.1464-410X.2006.06368.x CrossRef

16.

Bissada NK (1992) Conservative extirpative treatment of cancer of the penis. Urol Clin North Am 19(2):283–292PubMed

17.

Das S (1992) Penile amputation for the management of primary carcinoma of the penis. Urol Clin North Am 19(2):277–282PubMed

18.

Horenblas S, Van Tinteren H (1994) Squamous cell carcinoma of the penis. IV. Prognostic factors of survival: analysis of tumour, nodes, and metastatic classification system. J Urol 151:1239–1243PubMed

19.

Lindegaard JC, Nielsen OS, Lundbeck FA et al (1996) A retrospective analysis of 82 cases of cancer of the penis. BJUI 77(6):883–890. doi:10.1046/j.1464-410X.1996.02221.x CrossRef

20.

Lont AP, Gallee MPW, Meinhardt W, van Tinteren H, Horenblas S (2006) Penis conserving treatment for T1 and T2 penile carcinoma: clinical implications of a local recurrence. J Urol 176:575–580. doi:10.1016/j.juro.2006.03.063 PubMedCrossRef

21.

Austoni E, Fenice O, Kartalas Goumas Y et al (1996) New trends in the surgical treatment of penile carcinoma. Arch Ital Urol Androl 68:163–168PubMed

22.

Davis JW, Schellhammer PF, Schlossberg SM (1999) Conservative surgical therapy for penile and urethral carcinoma. Urology 53:386–392. doi:10.1016/S0090-4295(98)00483-X PubMedCrossRef

23.

Hatzichristou DG, Apostolidis A, Tzortzis V et al (2001) Glansectomy: an alternative surgical treatment for Buschke-Lowenstein tumours of the penis. Urology 57:966–969. doi:10.1016/S0090-4295(01)00942-6 PubMedCrossRef

24.

Pietrzak P, Corbishley C, Watkin NA (2004) Organ sparing surgery for invasive penile cancer. Early follow up data. BJUI 94:1253–1257. doi:10.1111/j.1464-410X.2004.05153.x CrossRef

25.

Chang TS, Hwang HY (1984) Forearm flap in one-stage reconstruction of the penis. Plast Reconstr Surg 74:251–258PubMedCrossRef

26.

Hoebeke PB, Rottey S, Van Heddeghem N, Villeirs G, Pauwels P, Schrauwen W et al (2007) One-stage penectomy and phalloplasty for epithelioid sarcoma of the penis in an adolescent. Eur Urol 51:1429–1432. doi:10.1016/j.eururo.2006.10.031 PubMedCrossRef

27.

Romero FW, Romero KR, Mattos MA, Garcia CR, Fernandez R de C, Perez MD (2005) Sexual function after partial penectomy for penile cancer. Urology 66:1292–1295PubMedCrossRef

28.

Miranda-Sousa A, Keating M, Moreira S, Baker M, Carrion R (2007) Concomitant ventral phalloplasty during penile implant surgery: a novel procedure that optimizes patient satisfaction and their perception of phallic length after penile implant surgery. J Sex Med 4:1494–1499. doi:10.1111/j.1743-6109.2007.00551.x PubMedCrossRef

29.

Shabbir M, Hughes BE, Swallow T, Corbishley C, Perry MJA, Watkin N (2008) Management of chronic ulceration after radiotherapy for penile cancer. J Urol 179(4):785

30.

Smith Y, Hadway P, Biedrzycki O et al (2007) Reconstructive surgery for invasive squamous carcinoma of the glans penis. Eur Urol 52(4):1179–1185. doi:10.1016/j.eururo.2007.02.038 PubMedCrossRef

31.

Smith Y, Hadway P, Ahmed S et al (2007) Penile-preserving surgery for male distal urethral carcinoma. BJUI 100(1):82–87. doi:10.1111/j.1464-410X.2007.06901.x CrossRef

Title: Penile preserving surgery and surgical strategies to maximize penile form and function in penile cancer: recommendations from the United Kingdom experience
Authors: Paul K. Hegarty
Majid Shabbir
Ben Hughes
Suks Minhas
Matthew Perry
Nicholas Watkin
David J. Ralph
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 2/2009
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-008-0312-x

At a glance: The STEP trials

Springer Medicine

Penile preserving surgery and surgical strategies to maximize penile form and function in penile cancer: recommendations from the United Kingdom experience

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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