title: [CCAFU french national guidelines 2016-2018 on penile cancer].
abstract: BACKGROUND
  The aim of this work is to establish guidelines proposed by the external genital organ group of the CCAFU for the diagnosis, treatment and follow-up of penile cancer.
  
  
  METHODS
  The multidisciplinary working party studied 2013 guidelines exhaustively reviewed the literature, and evaluated references and their level of proof in order to attribute grades of recommandation.
  
  
  RESULTS
  The most common histological type is squamous cell carcinoma. Clinical examination of the penis is usually sufficient to access local extension. It can be completed by MRI to assess deeper extension. Physical examination of both groins must evaluate inguinal regional lymph nodes involvement. In the presence of palpable lymph nodes, abdomen and pelvis computed tomography and18F-FDG PET-CT are recommended. Sentinel lymph node biopsy is recommended in the case of penile cancer with high risk of lymph node extension with no palpable lymph nodes. Treatment of the primary tumour is usually surgical. It must be as conservative as possible while ensuring negative surgical margins. Brachytherapy or local treatment can be proposed in some cases. Bilateral inguinal lymph node areas must be systematically treated. Inguinal lymphadenectomy alone has a curative role in patients with metastatic invasion of a single node (stage pN1). In the case of more extensive lymph node involvement, multimodal management combining chemotherapy, surgery, and possibly radiotherapy has to be considered.
  
  
  CONCLUSIONS
  The treatment of penile cancer is usually surgical possibly in combination with chemotherapy in the presence of lymph node extension. The main prognostic factor is lymph node involvement, requiring appropriate management at the time of diagnosis.x © 2016 Elsevier Masson SAS. All rights reserved.
authors.forename: P
authors.initials: P
authors.lastname: Sèbe
authors.forename: L
authors.initials: L
authors.lastname: Ferretti
authors.forename: P-H
authors.initials: PH
authors.lastname: Savoie
authors.forename: N
authors.initials: N
authors.lastname: Morel-Journel
authors.forename: A
authors.initials: A
authors.lastname: Fléchon
authors.forename: T
authors.initials: T
authors.lastname: Murez
authors.forename: L
authors.initials: L
authors.lastname: Rocher
authors.forename: P
authors.initials: P
authors.lastname: Camparo
authors.forename: A
authors.initials: A
authors.lastname: Méjean
authors.affiliation: Comité de cancérologie de l'Association française d'urologie, groupe organes génitaux externes, maison de l'urologie, 11, rue Viète, 75017 Paris, France.
authors.forename: X
authors.initials: X
authors.lastname: Durand
mesh_terms: D003663:Decision Trees; D006801:Humans; D008297:Male; D010412:Penile Neoplasms / Q000175:diagnosis* / Q000628:therapy*
keywords: Adénopathie inguinale; Cancer épidermoïde; Inguinal lymph node; Lymphadenectomy; Lymphadénectomie; Penectomy; Penile cancer; Pénectomie; Pénis; squamous cell carcinoma