title: New developments in the treatment of localized penile cancer.
abstract: OBJECTIVE
  To analyze the current trends in local therapy approaches in patients with penile carcinoma.
  
  
  METHODS
  The relevant published data since 2000 were reviewed; important series published before 2000 were also included. The reports were classified according to the level of evidence. Review studies and others indirectly related to the topic were also included but not classified.
  
  
  RESULTS
  New information has suggested that surgical margins of only a few millimeters might be adequate for most localized tumors. A trend toward the use of more conservative therapies instead of amputative surgery has been observed, especially in developed countries. Although the local recurrence rate has been greater after conservative therapies than after amputative surgery, this increased rate does not seemed to have had a negative effect on cancer-specific survival. The quality of life has been superior after conservative procedures with preservation of the penis that seems to give the best results with regard to sexual function. Reconstructive surgery can be performed in selected patients after amputative surgery.
  
  
  CONCLUSIONS
  Although the level of evidence is low, conservative therapies can be recommended for selected patients with penile carcinoma. Despite the trend for conservative approaches, these patients need psychological support.
authors.affiliation: Servicio de Urología, Instituto Valenciano de Oncología, C/Beltran Baguena 8, Valencia, Spain. solsona@pulso.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Solsona
authors.forename: Amit
authors.initials: A
authors.lastname: Bahl
authors.forename: Steven B
authors.initials: SB
authors.lastname: Brandes
authors.forename: David
authors.initials: D
authors.lastname: Dickerson
authors.forename: Antonio
authors.initials: A
authors.lastname: Puras-Baez
authors.forename: Hendrik
authors.initials: H
authors.lastname: van Poppel
authors.forename: Nick A
authors.initials: NA
authors.lastname: Watkin
mesh_terms: D032921:Consensus; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D010412:Penile Neoplasms / Q000628:therapy*; D011788:Quality of Life