FollowUp Recommendations

Based on the patterns of recurrence the following scheme is suggested. A maximum follow-up of 5 years is recommended. The majority of recurrences will develop within the first 2 years, hence there is more intense follow-up in these years. During the first 2 years, a 3-month follow-up is recommended in the patients who have undergone penile-preserving techniques and 6-month interval for patients undergoing a penile amputation. The role of self-examination by the patient should also be emphasized.

Regarding the follow-up of the regional lymph nodes during the first 2 years, a more intense follow-up is advised in the patients who underwent close surveillance (pNX), are staged with minimally invasive staging techniques (such as dynamic sentinel node biopsy), or staged pN+. Patients staged pN0 after prophylactic lymph-adenectomy have a lower risk of recurrence and can be managed less strictly with 6-month intervals in the first 2 years. Ultrasound with FNAC of suspicious-looking nodes is recommended when indicated in addition to a physical examination in order to detect metastases that are difficult to palpate. For all these groups mentioned above, the follow-up can be less intense in years 3, 4, and 5 (Table 14.2). Additional imaging should be performed on indication.

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