Surgical treatment of penile carcinoma: Our experience from 1976 to 1997

Objective: The purpose of this work is to evaluate; our experience with the surgical treatment of penile squamous carcinoma, analyzing the therapeutic results in terms of local recurrence rates, survival and mortality rates. Material and Methods: From 1976 to 1997, 47 patients were treated at our in stitution for carcinoma of penis. Treatment of primary tumor was conservati ve in 8 patients (17%). Partial penectomy was performed in 30 patients (63. 8%); total penectomy in 5 (10.7%) and emasculation in 4 (8.5%). Pathologica l stage was pTis in 2 cases (4.2%), pT1 in 20 (42.6%), pT2 in 21 (44.7%) an d pT3 in 4 (8.5%). The tumor was clinically overstaged in 13 patients (27.7 %) and understaged in 4 (8.5%). Bilateral inguinal lymphadenectomy was perf ormed only in 4 patients clinically N+ (pN2) and in 3 clinically N0 (pN0). Results:Local recurrence rate was 43% in the patients with pT1 stage tumor treated conservatively. No local recurrence was observed after penectomy. 1 9 patients (40.4%) are alive and disease-free; 17 patients (36.2%) died of the turner and 11 patients (23.4%) died of other causes but disease-free. M ean follow-up is 69.43 months. The overall 5-year survival rate was 34%. Co nclusion: Partial penectomy gives better results than conservative treatmen t in the local management of the T1 stage tumor. Survival and mortality rat es are related to both pathological and histological stages. The high morta lity rare observed in the pT2 stage tumors in our experience might be relat ed to the fact that in this stage an inguinal lymphadenectomy was not perfo rmed as a rule. Copyright 1999 S. Karger AG, Basel.