title: Surgical treatment of invasive squamous cell carcinoma of the penis: Brazilian National Cancer Institute long-term experience.
abstract: OBJECTIVE
  We reviewed our long-term experience with surgical treatment of patients with penile carcinoma.
  
  
  METHODS
  From 1960 to 2006, 688 patients with penile carcinoma underwent surgical treatment at our Institute. Several forms of surgical treatment were compared and follow-up data analyzed.
  
  
  RESULTS
  Stage stratification demonstrated a better survival rate for patients with stages T1N0 and T1N1,T2N0-1. Patients with well differentiated carcinoma had a higher survival rate than those with moderately and poorly differentiated carcinoma (P < 0.0001 and P = 0.006). Risk stratification showed a better survival rate for patients in the low-risk group (T1G1,T1G2) (P = 0.013 and P < 0.00001). Patients in the intermediate group (T2G1,T2G2,T3G1,T3G2) presented a higher survival rate than patients in the high-risk group (T1-3G3,T4G1-3) (P < 0.00001). Patients who underwent immediate lymphadenectomy had a better survival rate than those who underwent delayed lymphadenectomy (P = 0.002).
  
  
  CONCLUSIONS
  Stage and tumor grade affected the prognosis of the disease. The presence and the extent of metastasis to the inguinal region were the most important prognostic factors for survival in our patients. Immediate lymphadenectomy is indicated in all patients. Since recurrences were noted within 8, 10, and 25 years after primary treatment, a frequent and lasting follow-up is essential for all patients.
authors.affiliation: Section of Urology, National Institute of Cancer, Rio de Janeiro, Brazil. ornellasa@hotmail.com
authors.forename: Antonio Augusto
authors.initials: AA
authors.lastname: Ornellas
authors.forename: Eduardo Wei
authors.initials: EW
authors.lastname: Kinchin
authors.forename: Bernardo Lindenberg Braga
authors.initials: BL
authors.lastname: Nóbrega
authors.forename: Aristóteles
authors.initials: A
authors.lastname: Wisnescky
authors.forename: Nelson
authors.initials: N
authors.lastname: Koifman
authors.forename: Raul
authors.initials: R
authors.lastname: Quirino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome