title: Organ Sparing Surgery for Penile Cancer: A Systematic Review.
abstract: Although penile cancer represents only 1% of all male cancers, the traditional treatment, total or subtotal penectomy, carries devastating psychological and functional outcomes. Organ sparing surgery is an attractive option if it can provide satisfactory cancer control equivalent to or nearly equivalent to standard techniques. This approach is meeting increasing acceptance. We offer a timely comprehensive review to increase awareness of these procedures and their applicability, to evaluate the techniques objectively and to provide guidance to the practicing urologist.
  
  
  
  A PubMed® search was conducted using the key words "organ sparing/conserving" in "penile cancer" alone or in combination with "partial penectomy," "glansectomy," "glans resurfacing," "penile reconstruction," "laser," "Mohs," "outcomes" and "quality of life."
  
  
  
  Many techniques of organ sparing surgery in patients with penile cancer have been described through the years. To be practical and useful, a requirement of all these procedures is achievement of complete tumor excision confirmed by negative intraoperative frozen section and final pathological margins. Although organ sparing surgery carries a greater risk of local recurrence than penile amputation, overall patient survival is generally unaffected. Following strict indications and appropriate patient selection cancer specific survival after organ sparing surgery is equivalent to that of established techniques with the added benefits of improved quality of life and more acceptable morbidity.
  
  
  
  In properly selected patients with penile cancer organ sparing surgery provides comparable oncologic outcomes to conventional techniques, including total and subtotal amputations. Many patients are able to urinate while standing and a significant number are able to have intercourse.
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB). Electronic address: mkamel@uams.edu.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Kamel
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB).
authors.forename: Nabil
authors.initials: N
authors.lastname: Bissada
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB).
authors.forename: Renee
authors.initials: R
authors.lastname: Warford
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB).
authors.forename: Judy
authors.initials: J
authors.lastname: Farias
authors.affiliation: Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB).
authors.forename: Rodney
authors.initials: R
authors.lastname: Davis
mesh_terms: D000671:Amputation, Surgical / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D010412:Penile Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D010413:Penis / Q000473:pathology / Q000601:surgery; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods*; D014572:Urology / Q000379:methods / Q000592:standards
keywords: organ sparing treatments; penile neoplasms; quality of life; treatment outcome