Partial penectomy for patients with squamous cell carcinoma of the penis: The Memorial Sloan-Kettering experience

Background: To present our institution's experience with squamous cell carcinoma (SCC) of the penis, with analysis of oncologic efficacy and survival. Methods: Between 1989 and 2005, we identified 32 consecutive patients (median age, 61 years) with SCC of the penis managed with partial penectomy. Clinicopathologic variables were examined, and overall and disease-specific survival were determined. Results: Pathologic stage of the primary tumor was pTis in 1 patient (3%), pT1 in 11 (34%), pT2 in 16 (50%), and pT3 in 4 (13%). Pathologic grade was well differentiated in 9 patients (28%), moderately differentiated in 20 (63%), and poorly differentiated in 2 (6%). Twenty-five patients (78%) underwent inguinal lymph node dissection, with 15 (60%) demonstrating nodal metastases. Twenty-two patients (69%) underwent pelvic lymph node dissection; 21 were negative for pelvic nodal metastases, and 1 had grossly positive nodes. One patient developed local recurrence. After a mean follow-up of 34 months, overall survival was 56%. Numbers of patients alive and disease-free were 9 and 11 in the low-stage and advanced-stage groups, and 8 and 12 in the well and moderately differentiated groups, respectively. Both patients with poorly differentiated disease died of disease within 12 months from presentation. Conclusions: Partial penectomy for SCC of the penis provides excellent local control, with low recurrence rate, and acceptable maintenance of urinary and sexual function. Outcomes are generally poor, however, for patients with regional metastases, even in moderately differentiated disease. Future studies are needed to identify a reliable method of predicting regional metastases.