Penile cancer is rare. Thus, there are no therapeutic recommendations fulfi
lling the requirements of evidence-based medicine. The empirically based th
erapeutic approach consists of local excision, laser therapy, or radiothera
py with comparable local control rates. Radiation is delivered by external
beam radiotherapy or as brachytherapy. After radiotherapy, 5-year survival
rates of 66-92% and organ preservation in 55-84% are reported. Serious long
-term sequelae are necrosis (3-23%) and urethral stenosis (6-45%) requiring
surgery. In the adjuvant treatment of the locoregional lymph nodes, lympha
denectomy and radiotherapy of both inguinal regions are therapeutic options
.
Inguinal lymph node metastases may be irradiated pre- or postoperatively to
reduce the local recurrence rates. In addition, palliative radiotherapy of
the primary tumor, lymph node, or distant metastases is of use for incurab
le patients.
New combined therapies, e.g., radio-chemothermotherapy, are currently under
clinical evaluation and may offer a curative and organ-preserving therapeu
tic option to patients with locally advanced tumors.