Clinico pathological characteristics and surgical treatment of carcinoma of the penis: a single surgeon experience

Abstract

IntroductionCarcinoma of the penis is a disease of older men with an increased incidence in 6th decade of life. It is a rare malignancy in men with an annual incidence of one in 100,000 worldwide. Squamous cell carcinoma accounts for more than 95%of the penile malignancies. It has a significant geographical variation worldwide with a high prevalence in African and Asian countries. Usually these patients present late resulting in devastating complications and treatment challenges.sulting in devastating complications and treatment challenges.Methods and materials A retrospective analysis of data collected from 2009 to 2018 in four different provinces in Sri Lanka by the same author. Data were collected prospectively using a pro forma data sheet by the author. This study analyzed the clinico-pathological characteristics of consecutive patients with histopathologically proven penile cancer. Human papilloma virus (HPV) types, HPV-16 and HPV-18 were not assessed.ResultsTwenty eight patients with penile carcinoma were analyzed. The age ranged from 26 years to 86 with a mean age of 61.30.The commonest presentation was a non-healing ulcer on the glans (13/28). None of the patients had undergone circumcision and 10 patients had phimosis at presentation. Majority 67.85% of the patients presented within three months of recognizing the problem. Majority had involvement of the glans penis (24/28= 85.71%) at presentation. Palpable inguinal lymph nodes were found in 10 patients and eight of them had bilateral palpable inguinal lymphadenopathy. Surgical treatment varied from circumcision to total penectomy. Twenty four patients had conventional squamous cell carcinoma (SCC) while one patient had SCC in situ accounting for more than 85.71% of the tumour type to be squamous cell malignancy. Other types of malignancy detected were sarcomatoid SCC, Veruccous SCC and Basal cell carcinoma.ConclusionsThis study revealed that all patients were uncircumcised and 35.71% (10/28) of the subjects had phimosis at presentation which is considered as a risk factor for developing penile carcinoma. 35.71% of the patients were within the age group of 60 to 69 similar to international figures for age at peak incidence of the penile carcinoma. Commonest penile structures involved at presentation were foreskin and glans in keeping with international data. This observational study of penile carcinoma very clearly demonstrates and represents the similarity with the global pattern of this rare disease.