Current trends in the management of carcinoma penis - A review

Aims and introduction: To review the current literature, recent advances and recent trends in the management of squamous cell carcinoma of the penis so as to have a broad overview of penile cancer and its current management. The review was considered keeping in mind that squamous penile carcinoma is an infrequently encountered malignancy and that the etiology is still unclear though certain predisposing conditions are known to exist and also that controversy still exists as to the appropriate management of inguinal adenopathy. We also reviewed the etiological factors, clinical presentation, diagnosis, staging, prognostic factors in addition to management and prophylaxis. Methods: A literature search was carried out from Pubmed for indexed articles published over the last 50 years using the key words 'Management penile carcinoma', 'Squamous cell carcinoma penis' and 'inguinal lymphadenectomy'. Results: The search yielded over 1500 indexed published articles and reports. Important major reports and studies were reviewed, screened and tracked for recent changes and trends in the management of penile cancer. These were analyzed, tabulated and discussed. Conclusions: Newer approaches to the management of penile cancer include use of laser, photodynamic therapy, neoadjuvant therapy and sentinel node mapping by lympho-gamma-scintigraphy. The current approach towards managing inguinal adenopathy shows an increasing trend towards the use of these newer modalities as well as the use of certain modifications in lympadenectomy such as (the use of ligasure®, modified dissection, saphenous vein sparing and lymphoscintigraphy, etc. thereby making the procedure considerably less morbid than before. © 2004 Kluwer Academic Publishers.