Locally Advanced Penile Cancer

Traditionally patients with penile cancer have been surgically managed using one of three procedures, circumcision for preputial tumors, partial penectomy for distal tumors involving the glans penis or distal penile shaft, total penectomy combined with a perineal urethrostomy for more extensive tumors infiltrating into the proximal penile shaft. These techniques have been utilized in order to ensure clear tumor margins which traditionally have been defined as being 2 cm. However, studies have challenged this and demonstrated that smaller resection margins do not appear to compromise oncological control.1,6,7 More recently penile-preserving surgery such as glansectomy or wide local excisions with grafting have been employed in order to maintain penile length resulting in a more acceptable functional and cosmetic outcome. Partial penec-tomy and total penectomy procedures are now reserved for cases where penile-preserving surgical options are not suitable due to the extent of the disease.

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