Future Perspectives

Due to the relative rarity of penile cancer, fine-tuning of the molecular concept of penile carcinogenesis (see Fig. 2.1) is pending. Additional research to further delineate the sequence of molecular events underlying the development and progression of penile cancer and its precursor lesions is necessary to aid preventive, early detection, prognosis prediction and (targeted) therapeutic strategies for this highly mutilating disease. Particularly, the prognostic/therapeutic potential of investigating the expression of metastasis-promoting and metastasis suppressor genes would be interesting. Established metastasis-promoting genes include Ezrin (liver, ovary, prostate), S100A4 (breast, colon/rectum, prostate), and IGF-1 (breast, colon) and known metastasis-suppressor genes are annexin-7 (prostate) and KAI-1 (prostate, breast).However, with the advances in microarray Comparative Genomic Hybridization (maCGH), expression (mRNA/microRNA) array and deep-sequencing techniques, and initiatives to combine worldwide collections of tumors and (putative) precursor lesions within tumor registries and biobanks, it is hoped for that the molecular biology of penile cancer will be better understood within the next decade in order to facilitate improved outcomes for those men who suffer from the disease.

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