References

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Quality of Life and Psychosexual Issues

These issues, unfortunately, have been entirely neglected in most reports on penile cancer. This is surprising considering the possible major psychosexual impact of a penectomy. There are only a few small, mostly retrospective studies evaluating the quality of life and psychosexual issues (2,88,89). The expected quality of life, particularly sexual functions after treatment, should be specifically discussed with the patient. It is an expansive concept that involves vast and profound evaluation....

Pretreatment Evaluation and Pitfalls in Staging

For optimum management using the most appropriate treatment approach and ensuring best outcome, a simple but systematic pretreatment evaluation is mandatory. A careful history and interview should also include a history of sexual practices, sexually transmitted disease, chronic inflammatory penile conditions, and the likely psychosexual impact of a penectomy if recommended. The location, type, size, and extension of the tumor, presence of any premalignant or inflammatory condition, infection,...

Impalpable or Clinically Insignificant Groin Nodes

In patients with impalpable or clinically insignificant groin nodes with a negative FNAC, there is no consensus regarding selection of patients for close surveillance, sentinel node biopsy, or groin node dissection. Because clinical examination, imaging, and FNAC may miss subclinical nodal metastasis in up to 20 patients 3,24 , special diagnostic procedures such as sentinel node biopsy or limited surgery to identify occult metastases and prophylactic node dissection have been evaluated by...

Treatment Options in G3pT1 Disease

G3pT1 forms the watershed of therapeutic intervention, with advocates of conservative and radical intervention equally persuaded in their differing interpretation of the available data. The historical series suggest that untreated G3pT1 has a recurrence rate between 70 and 80 , and progression rates ranging from 29 to as high as 50 74 . In Birch and Harland's 75 review, 40 of G3pT1 cases followed beyond 24 months developed muscle-invasive disease. Although it is now accepted that treatment with...

Penile Conservative Therapy

Because amputative surgery for penile cancer may lead to major psychosexual dysfunction, various attempts have been made to devise conservative treatment modalities based on careful oncological, anatomical, and technical considerations. Judicious use of conventional or micrographic surgery, laser ablation, or radiotherapy can allow preservation of a functioning phallus in appropriately selected patients with early cancers. However, there are no comparative studies and no consensus regarding the...

Role of Bacille Calmette Gurin in the Treatment of Carcinoma in Situ

To date, BCG remains the treatment of choice for CIS disease. Although cytotoxic chemotherapy agents have shown initial response rates as good as 48 using anthracyclines and 53 for MMC, most series have demonstrated that this response is time limited, with fewer than 20 remaining disease free at 5 years 72 . This apparent chemoresistance may well reflect the high grade of CIS disease, whereas higher grade may imply greater antigenicity and therefore susceptibility to BCG immunotherapy. Bacille...

Contributors

Abel, ChM, FRCS Department of Surgery Faculty of Medicine Hammersmith Hospital Campus Imperial College London London, UK Genitourinary Medical Oncology Service Department of Medicine, Solid Tumour Oncology Memorial Hospital for Cancer and Allied Diseases Memorial Sloan-Kettering Cancer Center New York, NY, USA Simon Chowdhury, MB BS Department of Medicine Royal Marsden Hospital London, UK Timothy J. Christmas, MD, FRCS Urol Department of Urology Imperial College School of Medicine...