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The role of penectomy in penile cancer—evolving paradigms

Penile cancer is a rare cancer, with the majority treated with penile preserving methods. There remains a role for partial and totally penectomy for advanced and more proximal penile cancers. Significant functional and psychological morbidity can ensue for patients undergoing surgical management. Re...

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Autores principales: O’Neill, Sarah, Barns, Mitchell, Vujovic, Filip, Lozinskiy, Mikhail
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807362/
https://www.ncbi.nlm.nih.gov/pubmed/33457290
http://dx.doi.org/10.21037/tau.2019.08.14
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author O’Neill, Sarah
Barns, Mitchell
Vujovic, Filip
Lozinskiy, Mikhail
author_facet O’Neill, Sarah
Barns, Mitchell
Vujovic, Filip
Lozinskiy, Mikhail
author_sort O’Neill, Sarah
collection PubMed
description Penile cancer is a rare cancer, with the majority treated with penile preserving methods. There remains a role for partial and totally penectomy for advanced and more proximal penile cancers. Significant functional and psychological morbidity can ensue for patients undergoing surgical management. Recent studies and guidelines are changing the way Urologists approach surgical management of penile malignancies. Reductions in safe surgical margin recommendations from 2 cm to 3–5 mm provide surgeons with the ability to perform penile preserving techniques to maximise patient functionality. These guidelines are reflected by recent studies showing that smaller surgical margins; although heralding higher rates of local recurrence, have no detriment on cancer specific or overall survival rate. Although oncological clearance remains the primary outcome for surgical management of penile cancer, the ability to perform radical salvage surgery at a later date means patients are more likely to experience a longer period of functionality without sacrificing oncologic outcomes. The importance of patient education on regular self-examination as well as clinic follow up are key in identifying local recurrence and planning salvage surgery if needed to maintain oncologic control. Ongoing studies into the functional and psychological outcomes of patients undergoing partial penectomy show encouraging results however further studies are needed to elucidate long-term outcomes. The evolving paradigm of surgical management in penile malignancy is shifting to favour organ preserving techniques in order to maximise functional, psychological and aesthetic outcomes without compromising patients’ oncologic outcomes—however a role still exists for radical surgery in advanced penile malignancy.
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spelling pubmed-78073622021-01-15 The role of penectomy in penile cancer—evolving paradigms O’Neill, Sarah Barns, Mitchell Vujovic, Filip Lozinskiy, Mikhail Transl Androl Urol Review Article on Surgery for Urologic Cancers Penile cancer is a rare cancer, with the majority treated with penile preserving methods. There remains a role for partial and totally penectomy for advanced and more proximal penile cancers. Significant functional and psychological morbidity can ensue for patients undergoing surgical management. Recent studies and guidelines are changing the way Urologists approach surgical management of penile malignancies. Reductions in safe surgical margin recommendations from 2 cm to 3–5 mm provide surgeons with the ability to perform penile preserving techniques to maximise patient functionality. These guidelines are reflected by recent studies showing that smaller surgical margins; although heralding higher rates of local recurrence, have no detriment on cancer specific or overall survival rate. Although oncological clearance remains the primary outcome for surgical management of penile cancer, the ability to perform radical salvage surgery at a later date means patients are more likely to experience a longer period of functionality without sacrificing oncologic outcomes. The importance of patient education on regular self-examination as well as clinic follow up are key in identifying local recurrence and planning salvage surgery if needed to maintain oncologic control. Ongoing studies into the functional and psychological outcomes of patients undergoing partial penectomy show encouraging results however further studies are needed to elucidate long-term outcomes. The evolving paradigm of surgical management in penile malignancy is shifting to favour organ preserving techniques in order to maximise functional, psychological and aesthetic outcomes without compromising patients’ oncologic outcomes—however a role still exists for radical surgery in advanced penile malignancy. AME Publishing Company 2020-12 /pmc/articles/PMC7807362/ /pubmed/33457290 http://dx.doi.org/10.21037/tau.2019.08.14 Text en 2020 Translational Andrology and Urology. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Surgery for Urologic Cancers
O’Neill, Sarah
Barns, Mitchell
Vujovic, Filip
Lozinskiy, Mikhail
The role of penectomy in penile cancer—evolving paradigms
title The role of penectomy in penile cancer—evolving paradigms
title_full The role of penectomy in penile cancer—evolving paradigms
title_fullStr The role of penectomy in penile cancer—evolving paradigms
title_full_unstemmed The role of penectomy in penile cancer—evolving paradigms
title_short The role of penectomy in penile cancer—evolving paradigms
title_sort role of penectomy in penile cancer—evolving paradigms
topic Review Article on Surgery for Urologic Cancers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807362/
https://www.ncbi.nlm.nih.gov/pubmed/33457290
http://dx.doi.org/10.21037/tau.2019.08.14
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