Penile cancer is a rare disease and treatment approaches have been predominantly surgical. In early-stage disease high tumor control rates can be achieved but often at the price of considerable morbidity, mutilation, and functional impairment. In high-stage disease the results, even after aggressive surgical approaches, are disappointing with high recurrence rates and poor survival.

Organ-sparing approaches and multimodality approaches (combinations of surgery and/or radiation and/or chemotherapy) have never been explored in a large and prospective fashion.

This is in contrast with the situation in squamous cell cancer of other primary sites, such as head and neck cancer, cervical cancer, anal cancer, etc., where organ preservation and multimodality strategies have become the standard strategy.

The particular role of radiation in penile cancer remains unclear but the available literature, although limited and many times of rather poor quality, suggests that radiation response is comparable with radiation responses observed in other squamous cell carcinomas.

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