Conclusion

The options for patients with advanced penile cancers or cancers arising from the distal urethra with bulky nodal disease are limited as there are currently no effective chemotherapeutic regimens available. These patients often present with a poor performance status and are unlikely to tolerate the side effects of chemotherapy. Surgical resection of these lesions with reconstruction offers both symptom control and in those patients without M1 disease, a chance for cure. With the advent of novel tax-ane based combination therapy, neoadjuvant chemotherapy may allow previous non-responders to reduce the tumor burden and therefore allow surgical resection. However, further trials are required before this can become standardized and therefore at present the patients continue to be managed on a case by case approach.

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