title: A Prospective Study of Total Glans Resurfacing for Localized Penile Cancer to Maximize Oncologic and Functional Outcomes in a Tertiary Referral Network.
abstract: Penile cancer is a rare malignancy worldwide, representing only 1% of all cancers affecting men. There are little data outlining the comparative effectiveness of penile preservation techniques and to our knowledge no guidelines regarding their use currently exist. Outcomes data reporting is nonstandardized and followup is not measured consistently. The aim of this study was to analyze the outcomes of total glans resurfacing in terms of oncologic control, form and function in localized penile cancer.
  
  
  
  From 2013 to 2015, 19 prospectively enrolled patients underwent total glans resurfacing. Demographics, cosmesis, patient satisfaction and disease recurrence were assessed at followup to quantify oncologic and functional outcomes. At 3 months of followup patients completed the IIEF (International Index of Erectile Function) questionnaire detailing erectile and sexual function, and general satisfaction using a visual analog scale. All statistical analysis was performed with Prism® 6.
  
  
  
  No perioperative complications were experienced. Of the patients 94.7% had complete graft take with a median cosmesis score of 5 of 5 on the visual analog scale. There was 1 local and no regional nodal recurrence at a mean followup of 23 months. One-year progression-free and overall survival rates were 100% and the 1-year recurrence-free survival rate was 95%. Of the patients 81% reported an improved sex life postoperatively.
  
  
  
  Total glans resurfacing is a viable and acceptable option for glans preservation in patients with localized penile cancer. It demonstrates acceptable functional and oncologic outcomes. We believe that total glans resurfacing should be considered in all cases of localized penile cancer.
authors.affiliation: Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland. Electronic address: fokelly@rcsi.ie.
authors.forename: Fardod
authors.initials: F
authors.lastname: O'Kelly
authors.affiliation: Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Lonergan
authors.affiliation: Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland.
authors.forename: Dara
authors.initials: D
authors.lastname: Lundon
authors.affiliation: Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland.
authors.forename: Gregory
authors.initials: G
authors.lastname: Nason
authors.affiliation: Department of UroOncology, Mercy University Hospital, Cork, Republic of Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Sweeney
authors.affiliation: Department of Urology and Andrology, University Hospital, Waterford, Republic of Ireland.
authors.forename: Ivor
authors.initials: I
authors.lastname: Cullen
authors.affiliation: Department of Urological Surgery, Mater Misericordiae University Hospital, Dublin, Republic of Ireland.
authors.forename: Paul
authors.initials: P
authors.lastname: Hegarty
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010412:Penile Neoplasms / Q000401:mortality / Q000601:surgery*; D010413:Penis / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012017:Referral and Consultation; D015996:Survival Rate; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: penile neoplasms; reconstructive surgical procedures; skin transplantation; surveys and questionnaires; treatment outcome