title: Organ-preserving surgery for penile cancer: description of techniques and surgical outcomes.
abstract: Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Organ-preserving surgeries for penile cancer have been described to reduce the morbidity associated with traditional operations. Patients derive better functional outcomes from penile-preserving surgery, although local recurrence rates can be higher. Excellent results can be obtained at large-volume centres. With close follow-up, local recurrences can be identified and treated promptly (often with further local excision).
  
  
  OBJECTIVE
  • To describe the outcomes of organ-preserving surgery for penile cancer at a UK tertiary referral centre.
  
  
  METHODS
  • Patients at Sunderland Hospital (UK) between 2001 and 2008 who had squamous cell tumours limited to the glans penis underwent penile-preserving surgery including total glansectomy and glanuloplasty, partial glansectomy, glans relining and distal penectomy with glans reconstruction. • Recurrence rates, cosmetic and functional outcomes were recorded.
  
  
  RESULTS
  • In all, 65 patients were identified with a median follow-up of 40 months. Local recurrence was present in four patients (6%) despite 72% having intermediate or poorly differentiated tumours and 30% with T2 disease. • Complications included partial graft loss (1.5%), graft contractures (4.5%) and meatal stenosis (7.5%). • In all, 5% were deemed to have poor cosmetic outcome and 85% described good erections at 1 year after surgery.
  
  
  CONCLUSIONS
  • Penile-preserving surgery can achieve good penile cancer control with minimal morbidity and reduced psychosexual side-effects.
authors.affiliation: Department of Urology, Sunderland Royal Hospital, UK. veeratterapillayr@doctors.org.uk
authors.forename: Rajan
authors.initials: R
authors.lastname: Veeratterapillay
authors.forename: K
authors.initials: K
authors.lastname: Sahadevan
authors.forename: Pavan
authors.initials: P
authors.lastname: Aluru
authors.forename: Susan
authors.initials: S
authors.lastname: Asterling
authors.forename: G S
authors.initials: GS
authors.lastname: Rao
authors.forename: Damian
authors.initials: D
authors.lastname: Greene
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods*; D010412:Penile Neoplasms / Q000601:surgery*; D010413:Penis / Q000601:surgery*; D016896:Treatment Outcome