engleski

Penile cancer: Our experience over the last 13 years

Introduction Primary penile carcinoma is one of the rarest male genital tract tumors, with a reported incidence of 1 per 100000 males in Western European countries. More than 95% of penile cancers are squamous cell carcinomas (SCCs). It usually arises in the epithelium of the inner prepuce, coronal sulcus and glans. Social and cultural habits influence the incidence of the disease, which is related to the exposure to Human papilloma virus, poor hygiene, phimosis, chronic irritation and smoking. Penile carcinoma most commonly occurs in the fifth and sixth decade of life, with peak incidence in the eight decade. The aim of this retrospective study was to present our results of penile carcinoma surgical treatment, with emphasis on staging and complication rate. Patients and Methods From 1998-2010 we treated 25 penile carcinoma patients. Median age of the patients at the time of diagnosis was 62 years, range 45-92, with highest incidence in the sixth and seventh decade of life. Diagnostic procedures included detailed physical examination, patient history, and pelvic CT in patients with enlarged inguinal lymph nodes. Procedures performed included circumcision, partial/total penectomy, lymphadenectomy and adjuvant oncologic treatment. In most cases we performed intraoperative biopsy and cryosection procedure of the suspected lesion. Median follow up was 14 months, range 1-79 months. Results Of the total number of penile cancer patients 48% had palpable inguinal lymph nodes at the time of the diagnosis. Final pathological evaluation revealed 96% of SCCs and 4% of Kaposi sarcoma. Most commonly performed procedures were partial/total penectomy in 72%, inguinal lymphadenectomy in 48% and circumcision in 36% of the patients. In one patient we performed immediate total penectomy due to severe life- threatening hemorrhage. 52% of the patients were treated with adjuvant oncological treatment, while one patient received neoadjuvant radiotherapy only. In 2 patients the disease has recurrence locally. We had no major complications, wound dehiscence was noted in two and prolonged lymphorrea in five patients treated with regional lymphadenectomy. Discussion Due to the relatively rare occurrence, age at the time of diagnosis and poorly educated population, majority of our patients have neglected early lesions for more than one year until they make first visit to their physician, which caused the delay of diagnosis and, subsequently, often inadequate treatment.

penile cancer ; urologic surgical procedures

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