Organ-preserving surgery for penile cancer: description of techniques and surgical outcomes

Abstract

Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Organ-preserving surgeries for penile cancer have been described to reduce the morbidity associated with traditional operations. Patients derive better functional outcomes from penile-preserving surgery, although local recurrence rates can be higher. Excellent results can be obtained at large-volume centres. With close follow-up, local recurrences can be identified and treated promptly (often with further local excision).

Objective: • To describe the outcomes of organ-preserving surgery for penile cancer at a UK tertiary referral centre.

Patients and methods: • Patients at Sunderland Hospital (UK) between 2001 and 2008 who had squamous cell tumours limited to the glans penis underwent penile-preserving surgery including total glansectomy and glanuloplasty, partial glansectomy, glans relining and distal penectomy with glans reconstruction. • Recurrence rates, cosmetic and functional outcomes were recorded.

Results: • In all, 65 patients were identified with a median follow-up of 40 months. Local recurrence was present in four patients (6%) despite 72% having intermediate or poorly differentiated tumours and 30% with T2 disease. • Complications included partial graft loss (1.5%), graft contractures (4.5%) and meatal stenosis (7.5%). • In all, 5% were deemed to have poor cosmetic outcome and 85% described good erections at 1 year after surgery.

Conclusion: • Penile-preserving surgery can achieve good penile cancer control with minimal morbidity and reduced psychosexual side-effects.