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Organ-sparing surgery for penile cancer: complications and outcomes.

Urology 2011 November
OBJECTIVE: To evaluate the complications and outcomes of organ-sparing surgery in penile cancer.

METHODS: Thirty-two penile cancer patients had undergone organ-sparing surgery between 2006 and 2010 in Fudan University Shanghai Cancer Center. Applied surgical techniques included radical circumcision and/or wide local excision. Intraoperative frozen section analyses of circumference and deep margins were performed to guarantee complete removal of cancerous tissue. Complications and oncological and functional outcomes were recorded prospectively. Bilateral inguinal lymphadenectomy was routinely performed in patients with invasive penile cancer.

RESULTS: Of 32 patients, 8 underwent radical circumcision, 18 were treated with wide local excision, and 6 received wide local excision and circumcision. Postoperatively, only 3 (9.4%) patients had minor complications. With a median follow-up of 26.5 months, local control was achieved in 29 (90.6%) patients, and 3 patients (9.4%) with positive lymph nodes died of disseminated disease. Of 29 patients who completed follow-up surveys of functional outcome, only 1 (4.5%) claimed decreased sexual function and all reported satisfied urination.

CONCLUSION: Organ-sparing surgery, such as radical circumcision and wide local excision is an appropriate treatment option for selected penile cancer patients. It preserves sexual and urination function without significantly increasing the risk of recurrence.

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