[Penile cancer: diagnosis and staging]. / Peniskarzinom: Diagnose und Staging.

Penile cancer is often an obvious visual diagnosis but histologic verification should be obtained prior to treatment. The clinical examination should determine the tumor stage and whether it has infiltrated the cavernous bodies and/or the urethra and it should adequately assess the inguinal lymph nodes. Preoperative imaging of the lesion is only indicated in equivocal cases. Curative treatment requires the complete removal of the primary tumor and all metastatic lymph nodes. Lymph node management is the key prognostic factor in the treatment of penile cancer. No imagining technique such as the ultrasound, CT, MRI or PET/CT is able to adequately detect micrometastatic lymph nodes. Therefore, invasive (inguinal) lymph node diagnosis is indicated for all tumour stages from pT1G2. Over 90% of penile cancer cases can be cured with early diagnosis and adequate treatment if routine self-examination and physical examinations are regularly performed.

[Psychosocial effects in patients with penile cancer : A systematic review]. / Psychosoziale Auswirkungen bei Patienten mit Peniskarzinom : Ein systematischer Überblick.

BACKGROUND: Psychological stress of patients with penile cancer arises from the cancer diagnosis itself and the treatment consequences. In addition, there is cancer-specific distress. There is the chance of cure in localized stages and in those with limited regional lymph node metastases but this requires surgery and often adjuvant chemotherapy. This systematic review gives a summary of the existing literature to date. MATERIALS AND METHODS: A critical database search using Medline was made in Ovid from 1946 to 2017, in the Cochrane Central Register of Controlled Trials (CENTRAL) and in the Web of Science from 1900 to 2017. This was complemented by a search of the World Health Organization's International Clinical Trials Registry Platform Search Portal and ClinicalTrials.gov. The reference lists of the included studies were manually searched for additional references. RESULTS: Selected studies (n = 10) addressed the psychosocial effects of penile cancer treatment on quality of life and sexual function. Due to the heterogeneity of the study designs only a narrative description of the results was possible. Defects or mutilation due to penile cancer cause psychological distress in a significant number of patients. Organ-sparing interventions have a positive impact on quality of life and sexual function. CONCLUSION: The external genitals are a focus of sexual identity. Mutilating treatment causes significant distress but organ-sparing treatment and reconstruction positively influence quality of life.

[Lymph-node-positive penile cancer : Management and systemic therapy]. / Lymphknotenpositives Peniskarzinom : Management und systemische Therapie.

Cancer-specific survival in men with penile cancer depends foremost on regional lymphatic metastasis and its extent. Patients with limited inguinal lymph node metastases have a 5-year survival of up to 80%. However, those with pelvic lymph node metastases and/or systemic disease have a 5-year survival prognosis of only 0-33%. In any case, in patients with regional lymph node metastases multimodal treatment with complete lymphadenectomy and adjuvant chemotherapy is indicated.

[The current state of the art of chemotherapy of penile cancer: results of a nationwide survey of German clinics]. / Die aktuelle Situation der Chemotherapie des Peniskarzinoms : Ergebnisse einer deutschlandweiten Klinikumfrage.

INTRODUCTION: The prognosis for advanced penile carcinomas is extremely poor. Due to the low response rates and relevant side effects of current chemotherapy regimens, several attempts have been made to improve chemotherapy in recent years. In a retrospective survey the current state of the art of chemotherapy for penile carcinoma in Germany was analysed. METHODS: The study took the form of a retrospective survey among all urological departments in Germany. The questionnaire contained seven questions concerning indications and modalities for chemotherapy of penile carcinoma in addition to general questions. RESULTS: Out of 280 departments 129 (46%) returned an answered questionnaire. Chemotherapy was reported to be carried out by 91 of the answering departments and overall 18 different chemotherapy regimens were used. The regimens cisplatin/methotrexate/bleomycin, vinblastin/methotrexate/bleomycin and cisplatin/5FU were the most frequently reported. Chemotherapy was carried out on average 2.3 times per year per department. The majority of the departments reported response rates under 30%. Finally 101 of the answering departments confirmed the necessity of new chemotherapy regimens. CONCLUSIONS: The current state of the art for chemotherapy of penile carcinoma showed a very large variation in Germany. The response rates were disappointing. A nationwide study with new chemotherapy approaches is urgently needed (information under www.uni-rostock.de/peniskarzinom).