INTRODUCTION: Treatment of penile carcinoma, even if it is well codified, is not well known because of its rarity. The aim of this article is to report the management of penile carcinoma in 2010. PATIENTS AND METHODS: This article is a summary of the forum of the Committee of Oncology of the French Association of Urology (AFU-CC), held at the Congress of the AFU.
RESULTS: The role of the urologist is to diagnose precancerous lesions and penile carcinomas beginners to limit the risk of mutilating treatments. In case of doubt, a biopsy with orientation must be performed. The extension of the tumor is mainly based on clinical examination. Penile MRI can help to assess the depth extension. The treatment of penile tumor must be the most conservative either with surgery or brachytherapy. The risk of local recurrence, after conservative treatment, is 20 % but does not influence survival. The management of lymph nodes should be systematic, bilateral and performed at diagnosis. Tumors greater or equal to pT1b and/or grade greater or equal to 2 are at risk of lymph node extension. The staging of lymph node and distance metastase is clinical and radiological (CT and/or PET-CT 18F-FDG). The inguinal lymphadenectomy have a curative role. The type of inguinal lymphadenectomy (modified and/or total) is based on clinical examination, para-clinical and fine needle aspiration of lymph nodes. In some cases, associated pelvic lymph node dissection is recommended. The place and the type of chemotherapy remain to be defined. This treatment is based at least on the administration of cisplatin.
CONCLUSION: The treatment of penile carcinoma requires a local treatment of the tumor as conservative as possible. The management of inguinal lymph nodes is important because of its prognostic value. It must be made at initial diagnosis and is based on clinical and para-clinical examinations.
Written by:
Souillac I, Avances C, Camparo P, Culine S, Durand X, Haie-Meder C, Sebe P, Soulie M, Rigaud J Are you the author?
Clinique d'urologie, CHU Hôtel-Dieu, Nantes, France
Reference: Prog Urol. 2011 Dec;21(13):909-16
doi: 10.1016/j.purol.2011.08.031.
PubMed Abstract
PMID: 22118355
[Article in French]