Patterns of Recurrence

The majority of recurrences in penile carcinoma develop within 5 years after the primary treatment. Within this the largest proportion will occur within 2 years after the initial treatment. The interval between treatment and recurrence seems to be dependent on the type of relapse. Recent data from a large two-institutional retrospective study involving 700 patients has shown that 66% of local recurrences, 86%

Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

Fig. 14.1 Cumulative risk of recurrence (in patients with a simultaneous local and

Fig. 14.1 Cumulative risk of recurrence (in patients with a simultaneous local and regional or distant recurrence, the local recurrence was taken into account). (Adapted from Leijte et al.1)

0-700 523 365 279 224 168 132 98

0 6 12 18 24 30 36 42 48 54 60 66 72 78 84 Time from diagnosis regional or distant recurrence, the local recurrence was taken into account). (Adapted from Leijte et al.1)

0-700 523 365 279 224 168 132 98

0 6 12 18 24 30 36 42 48 54 60 66 72 78 84 Time from diagnosis of regional recurrence, and all distant recurrences were detected within the first 2 years, respectively (see Fig. 14.1 and Table 14.1).1 Consequently, follow-up should be intense during the first 2 years after surgery. A maximal follow-up of 5 years seems reasonable to detect the majority of recurrences. Similar to other types of solid tumors, a second primary tumor could develop because the remaining epithelium of the glans of the penis remains "at risk" for developing a malignancy or because of prolonged exposure to an etiological factor (i.e. HPV infection) when penile-preserving surgery has been performed.

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