22 Penis Cancer

Penis Cancer 491

In case of urethral stenosis (10 - 20%), dilatation may allow successful symptom relief in up to 90% of cases. This dilatation is started by the urologist (Fig 21.14) and later performed regularly by the patient. (5,11) The most important complication is necrosis (10 - 15%), firstly because of severe pain which can last several months; secondly because of the difficult differential diagnosis between “pure” necrosis (Fig 21.15) and necrosis associated with local recurrence. Local antiseptic therapy associated with antibiotic therapy should be prescribed. If response is poor and tumour recurrence or residual tumour suspected, a limited, careful biopsy should be taken to establish the diagnosis. (7,14,31) Slow decrease in the size of the penis may occur after more than 2 years, due to progressive fibrosis. This can be complicated by a neoprepuce, constituting a handicap for sexual life. (5,14) 12 References 1. Akimoto T, Mitsuhashi, Takahashi I, et al. Brachytherapy for penile cancer using silicon mould. Oncology 1997; 54 : 23-7. 2. Ayyappan K, Anamthakrishnan N, Sankaran V. Can regional lymph node involvement be predicted in patients with carcinoma of the penis? Br J Urol 1994; 73 : 549-53. 3. Barton Crossman H. Premalignant and early carcinoma of the penis and scrotum. In: Crawford DE, Das S. (eds) Penile, urethral, and scrotal cancer. The Urologic Clinics of North America . Philadelphia: W.B. Saunders 1992; 221-6. 4. Bouchot O, Bouvier S, Bocherau G, Jeddi M. Cancer of the penis: the value of systematic biopsy of the surgical inguinal lymph nodes in clinical N0 stage patients. Progr Urol 1993; 3 : 228-33. 5. Chassagne D, Wibault P, Court B. Tumeur de la verge. Encycl Med Chir (Rein) . Paris 1978; 11 : 18375 A10. 6. Chaudhary AJ, Ghosh S, Bhalavat RL, et al. Interstitial brachytherapy in carcinoma of the penis. Strahlenth Oncol 1999; 175 : 17-20. 7. Clifford Chao KD, Perez CA. Penis and male urethra. In: Perez CA, Brady LW (eds.): Principles and practice of radiation oncology (3 rd edition). Philadelphia: Saunders-Lippincott-Raven 1997; 1717-31. 8. Clifford and Perez. Results from external beam therapy 9. Delannes M, Malavaud V, Douchez J, et al. Iridium-192 interstitial radiation therapy for squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys 1984; 10 : 1891-5. 10. Gerbaulet A. Cancers de la verge. In: Steg A, Eschwege F. (ed.) Cancers uro-genitaux . Paris: Flammarion Medecine Science 1991; 406-24. 11. Gerbaulet A, Lambin P. Radiation therapy of cancer of the penis: indications, advantages and pitfalls. In: Crawford DE, Das S. (eds) Penile, urethral, and scrotal cancer . The Urologic Clinics of North America . Philadelphia: W.B. Saunders 1992; 325-32. 12. Gerbaulet A, Delapierre M, Haie-Meder C, Lambin P, et al. La curiethérapie du cancer de la verge. A propos d` un nouveau…GAG (gland applicateur de Gerbaulet) . Bull Cancer Radiother 1992; 79 : 95-100. 13. Gerbaulet A, Lambin P, Haie-Meder C, et al. Brachytherapy in penile cancer. Ann Urol 1994; 28 : 306-11. 14. Gerbaulet A. Tumours of the penis. In: Souhami RL, Tannock I, Hohenberger P, Horiot JC (eds) Oxford textbook of Oncology (2 nd edition). Oxford University Press-Oxford, New York 2002; 2047- 56 15. Gregoire L, Cubilla AL, Reuter VE, et al.. Preferential association of human papilloma virus with high-grade histologic variants of penile-invasive squamous-cell carcinoma. J Natl Cancer Inst 1995; 87 : 1705-9.