Ozsahin M et al. (2006) Treatment of penile carcinoma: to cut or not to cut? Int J Radiat Oncol Biol Phys 66: 674–679

The traditional treatment for squamous-cell carcinoma of the penis is partial or total penectomy, which causes the patient considerable psychological distress. Organ-sparing treatments would be preferable to the patient, but there is a lack of randomized studies that compare the outcomes of the available options. A team of Swiss and French researchers have conducted a retrospective study of men who received various treatments for penile cancer.

Ozsahin et al. analyzed the records of 60 consecutive patients with nonmetastatic, invasive squamous-cell carcinoma of the penis, who were treated between 1962 and 1994. Overall, 27 patients underwent partial or total penectomy, 8 patients received brachytherapy, 21 patients received primary external radiotherapy, and 4 patients refused radiotherapy after excisional biopsy; 22 of 27 penectomy patients and 7 of 8 brachytherapy patients also received postprocedure external radiotherapy.

Local failure was more common in patients who had undergone organ-sparing procedures than in patients who had undergone penectomy (56% versus 13%, P = 0.0008); however, no difference in survival was seen between penectomy patients and patients who had received primary radiotherapy. The authors propose that primary radiotherapy is a reasonable treatment option, if patients are closely followed up. It should be noted that, because of the retrospective design of the study, it was not possible to assess penile function, which might be affected even by organ-sparing treatment.