title: [Epithelioma of the penis treated with surgery. Study Group on Urogenital Tumors of the National Federation of the Centers for Cancer Control].
abstract: OBJECTIVE
  To evaluate the efficacy and morbidity of surgical treatment of carcinoma of the penis. This series of patients was derived from a retrospective multicentre study (1959-1989), initially concerning 506 patients, all treatments combined.
  
  
  METHODS
  One hundred and sixty-eight patients treated by surgery or surgery followed by external radiotherapy between 1959 to 1989 were included. The mean follow-up is 14.4 years and the mean participation is 4.7 years. Total or partial amputation was performed as first-line treatment in 89 patients (53%) and as second-line treatment in 11 patients (7%). Thirty-two patients received external radiotherapy as a complement to surgery. Inguinal lymph node dissection was performed as first-line treatment in 68 patients (41%) and secondarily in 19 patients (11%). Postoperative inguinal radiotherapy was performed in 52 patients. Monofactorial statistical analysis of prognostic factors is proposed.
  
  
  RESULTS
  The 5-year local control rate was 84%; it was independent of the stage of the tumour; the survival of the patients dying from any cause was 53%, the progression-free survival was 69% and the survival of patients dying from cancer of the penis was 75%. The vital prognosis is statistically significant related to the lymph node status. No significant relationship was observed between lymph node status and tumour stage. 61 complications involving the penis were observed in 40 patients (24%). Thirty-seven patients developed complications secondary to the lymph node dissection (24 cases of oedema of the lower limbs and 13 cases of inguinal sclerosis).
  
  
  CONCLUSIONS
  Surgical treatment ensured a local control globally comparable to that obtained with brachytherapy, but unlike this technique, the local control is independent of the stage. Brachytherapy should not always be performed in favour of mutilation for advanced tumours because the iatrogenic effects of brachytherapy are increased in these cases. An approach to the treatment of lymph nodes is proposed based on the authors' experience and the data of the literature.
authors.affiliation: Centre Régional de Lutte contre le Cancer Jean Perrin, Clermont-Ferrand, France.
authors.forename: R
authors.initials: R
authors.lastname: Rozan
authors.forename: E
authors.initials: E
authors.lastname: Albuisson
authors.forename: B
authors.initials: B
authors.lastname: Giraud
authors.forename: J P
authors.initials: JP
authors.lastname: Boiteux
authors.forename: J
authors.initials: J
authors.lastname: Dauplat
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010412:Penile Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
vernacular_title: Epithéliomas de la verge traités par chirurgie. Groupe d'Etudes des Tumeurs Uro-génitales de la Fédération Nationale des Centres de lutte contre le cancer.