572 lines
No EOL
116 KiB
HTML
572 lines
No EOL
116 KiB
HTML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK65943" /><meta name="ncbi_domain" content="pdqcis" /><meta name="ncbi_report" content="record" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK65943.5/" /><meta name="ncbi_pagename" content="Penile Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf" /><meta name="ncbi_bookparttype" content="chapter" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Penile Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Penile Cancer Treatment (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2018/01/30" /><meta name="citation_author" content="PDQ Adult Treatment Editorial Board" /><meta name="citation_pmid" content="26389381" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK65943/" /><meta name="citation_keywords" content="penile cancer" /><meta name="citation_keywords" content="penile cancer" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Penile Cancer Treatment (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Adult Treatment Editorial Board" /><meta name="DC.Date" content="2018/01/30" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK65943/" /><meta name="description" content="Penile cancer treatment options include surgery and radiation therapy depending upon tumor size, location, invasiveness, and stage. Get detailed information about the treatment of newly diagnosed and recurrent penile cancer in this summary for clinicians." /><meta name="og:title" content="Penile Cancer Treatment (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Penile cancer treatment options include surgery and radiation therapy depending upon tumor size, location, invasiveness, and stage. Get detailed information about the treatment of newly diagnosed and recurrent penile cancer in this summary for clinicians." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK65943/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000062897/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK65943/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8D6E197C9333E100000000008F007B.m_13" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/4008682/4207974/4206132/4062871/12930/3964959/3854974/36029/4128070/9685/3549676/3609192/3609193/3609213/3395586.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
<div id="universal_header">
|
|
<section class="usa-banner">
|
|
<div class="usa-accordion">
|
|
<header class="usa-banner-header">
|
|
<div class="usa-grid usa-banner-inner">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png" alt="U.S. flag" />
|
|
<p>An official website of the United States government</p>
|
|
<button class="non-usa-accordion-button usa-banner-button" aria-expanded="false" aria-controls="gov-banner-top" type="button">
|
|
<span class="usa-banner-button-text">Here's how you know</span>
|
|
</button>
|
|
</div>
|
|
</header>
|
|
<div class="usa-banner-content usa-grid usa-accordion-content" id="gov-banner-top" aria-hidden="true">
|
|
<div class="usa-banner-guidance-gov usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg" alt="Dot gov" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The .gov means it's official.</strong>
|
|
<br />
|
|
Federal government websites often end in .gov or .mil. Before
|
|
sharing sensitive information, make sure you're on a federal
|
|
government site.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
<div class="usa-banner-guidance-ssl usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg" alt="Https" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The site is secure.</strong>
|
|
<br />
|
|
The <strong>https://</strong> ensures that you are connecting to the
|
|
official website and that any information you provide is encrypted
|
|
and transmitted securely.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<div class="usa-overlay"></div>
|
|
<header class="ncbi-header" role="banner" data-section="Header">
|
|
|
|
<div class="usa-grid">
|
|
<div class="usa-width-one-whole">
|
|
|
|
<div class="ncbi-header__logo">
|
|
<a href="/" class="logo" aria-label="NCBI Logo" data-ga-action="click_image" data-ga-label="NIH NLM Logo">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg" alt="NIH NLM Logo" />
|
|
</a>
|
|
</div>
|
|
|
|
<div class="ncbi-header__account">
|
|
<a id="account_login" href="https://account.ncbi.nlm.nih.gov" class="usa-button header-button" style="display:none" data-ga-action="open_menu" data-ga-label="account_menu">Log in</a>
|
|
<button id="account_info" class="header-button" style="display:none" aria-controls="account_popup" type="button">
|
|
<span class="fa fa-user" aria-hidden="true">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" width="20px" height="20px">
|
|
<g style="fill: #fff">
|
|
<ellipse cx="12" cy="8" rx="5" ry="6"></ellipse>
|
|
<path d="M21.8,19.1c-0.9-1.8-2.6-3.3-4.8-4.2c-0.6-0.2-1.3-0.2-1.8,0.1c-1,0.6-2,0.9-3.2,0.9s-2.2-0.3-3.2-0.9 C8.3,14.8,7.6,14.7,7,15c-2.2,0.9-3.9,2.4-4.8,4.2C1.5,20.5,2.6,22,4.1,22h15.8C21.4,22,22.5,20.5,21.8,19.1z"></path>
|
|
</g>
|
|
</svg>
|
|
</span>
|
|
<span class="username desktop-only" aria-hidden="true" id="uname_short"></span>
|
|
<span class="sr-only">Show account info</span>
|
|
</button>
|
|
</div>
|
|
|
|
<div class="ncbi-popup-anchor">
|
|
<div class="ncbi-popup account-popup" id="account_popup" aria-hidden="true">
|
|
<div class="ncbi-popup-head">
|
|
<button class="ncbi-close-button" data-ga-action="close_menu" data-ga-label="account_menu" type="button">
|
|
<span class="fa fa-times">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 48 48" width="24px" height="24px">
|
|
<path d="M38 12.83l-2.83-2.83-11.17 11.17-11.17-11.17-2.83 2.83 11.17 11.17-11.17 11.17 2.83 2.83 11.17-11.17 11.17 11.17 2.83-2.83-11.17-11.17z"></path>
|
|
</svg>
|
|
</span>
|
|
<span class="usa-sr-only">Close</span></button>
|
|
<h4>Account</h4>
|
|
</div>
|
|
<div class="account-user-info">
|
|
Logged in as:<br />
|
|
<b><span class="username" id="uname_long">username</span></b>
|
|
</div>
|
|
<div class="account-links">
|
|
<ul class="usa-unstyled-list">
|
|
<li><a id="account_myncbi" href="/myncbi/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_myncbi">Dashboard</a></li>
|
|
<li><a id="account_pubs" href="/myncbi/collections/bibliography/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_pubs">Publications</a></li>
|
|
<li><a id="account_settings" href="/account/settings/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_settings">Account settings</a></li>
|
|
<li><a id="account_logout" href="/account/signout/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_logout">Log out</a></li>
|
|
</ul>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
</header>
|
|
<div role="navigation" aria-label="access keys">
|
|
<a id="nws_header_accesskey_0" href="https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys" class="usa-sr-only" accesskey="0" tabindex="-1">Access keys</a>
|
|
<a id="nws_header_accesskey_1" href="https://www.ncbi.nlm.nih.gov" class="usa-sr-only" accesskey="1" tabindex="-1">NCBI Homepage</a>
|
|
<a id="nws_header_accesskey_2" href="/myncbi/" class="set-base-url usa-sr-only" accesskey="2" tabindex="-1">MyNCBI Homepage</a>
|
|
<a id="nws_header_accesskey_3" href="#maincontent" class="usa-sr-only" accesskey="3" tabindex="-1">Main Content</a>
|
|
<a id="nws_header_accesskey_4" href="#" class="usa-sr-only" accesskey="4" tabindex="-1">Main Navigation</a>
|
|
</div>
|
|
<section data-section="Alerts">
|
|
<div class="ncbi-alerts-placeholder"></div>
|
|
</section>
|
|
</div>
|
|
<div class="header">
|
|
<div class="res_logo"><h1 class="res_name"><a href="/books/" title="Bookshelf home">Bookshelf</a></h1><h2 class="res_tagline"></h2></div>
|
|
<div class="search"><form method="get" action="/books/"><div class="search_form"><label for="database" class="offscreen_noflow">Search database</label><select id="database"><optgroup label="Recent"><option value="books" selected="selected" data-ac_dict="bookshelf-search">Books</option><option value="pcsubstance">PubChem Substance</option><option value="pubmed">PubMed</option><option value="clinvar" class="last">ClinVar</option></optgroup><optgroup label="All"><option value="gquery">All Databases</option><option value="assembly">Assembly</option><option value="biocollections">Biocollections</option><option value="bioproject">BioProject</option><option value="biosample">BioSample</option><option value="books" data-ac_dict="bookshelf-search">Books</option><option value="clinvar">ClinVar</option><option value="cdd">Conserved Domains</option><option value="gap">dbGaP</option><option value="dbvar">dbVar</option><option value="gene">Gene</option><option value="genome">Genome</option><option value="gds">GEO DataSets</option><option value="geoprofiles">GEO Profiles</option><option value="gtr">GTR</option><option value="ipg">Identical Protein Groups</option><option value="medgen">MedGen</option><option value="mesh">MeSH</option><option value="nlmcatalog">NLM Catalog</option><option value="nuccore">Nucleotide</option><option value="omim">OMIM</option><option value="pmc">PMC</option><option value="protein">Protein</option><option value="proteinclusters">Protein Clusters</option><option value="protfam">Protein Family Models</option><option value="pcassay">PubChem BioAssay</option><option value="pccompound">PubChem Compound</option><option value="pcsubstance">PubChem Substance</option><option value="pubmed">PubMed</option><option value="snp">SNP</option><option value="sra">SRA</option><option value="structure">Structure</option><option value="taxonomy">Taxonomy</option><option value="toolkit">ToolKit</option><option value="toolkitall">ToolKitAll</option><option value="toolkitbookgh">ToolKitBookgh</option></optgroup></select><div class="nowrap"><label for="term" class="offscreen_noflow" accesskey="/">Search term</label><div class="nowrap"><input type="text" name="term" id="term" title="Search Books. Use up and down arrows to choose an item from the autocomplete." value="" class="jig-ncbiclearbutton jig-ncbiautocomplete" data-jigconfig="dictionary:'bookshelf-search',disableUrl:'NcbiSearchBarAutoComplCtrl'" autocomplete="off" data-sbconfig="ds:'no',pjs:'no',afs:'no'" /></div><button id="search" type="submit" class="button_search nowrap" cmd="go">Search</button></div></div></form><ul class="searchlinks inline_list"><li>
|
|
<a href="/books/browse/">Browse Titles</a>
|
|
</li><li>
|
|
<a href="/books/advanced/">Advanced</a>
|
|
</li><li class="help">
|
|
<a href="/books/NBK3833/">Help</a>
|
|
</li><li class="disclaimer">
|
|
<a target="_blank" data-ga-category="literature_resources" data-ga-action="link_click" data-ga-label="disclaimer_link" href="https://www.ncbi.nlm.nih.gov/books/about/disclaimer/">Disclaimer</a>
|
|
</li></ul></div>
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<!-- Custom content 1 -->
|
|
<div class="col1">
|
|
|
|
</div>
|
|
|
|
<div class="container">
|
|
<div id="maincontent" class="content eight_col col">
|
|
<!-- Custom content in the left column above book nav -->
|
|
<div class="col2">
|
|
|
|
</div>
|
|
|
|
<!-- Book content -->
|
|
|
|
|
|
<!-- Custom content between navigation and content -->
|
|
<div class="col3">
|
|
|
|
</div>
|
|
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65943_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65943_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65943_"><span class="title" itemprop="name">Penile Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Health Professional Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: January 30, 2018.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062897__206">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of penile cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p><p id="CDR0000062897__207">This summary is reviewed regularly and updated as necessary by the PDQ Adult Treatment Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p></div><div id="CDR0000062897__1"><h2 id="_CDR0000062897__1_">General Information About Penile Cancer</h2><div id="CDR0000062897__180"><h3>Incidence and Mortality</h3><p id="CDR0000062897__131">Estimated new cases and deaths from penile (and other male genital) cancer in the United States in 2018:[<a class="bk_pop" href="#CDR0000062897_rl_1_1">1</a>]</p><ul id="CDR0000062897__132"><li class="half_rhythm"><div>New cases: 2,320.</div></li><li class="half_rhythm"><div>Deaths: 380.</div></li></ul></div><div id="CDR0000062897__196"><h3>Risk Factors</h3><p id="CDR0000062897__197">
|
|
Penile cancer is rare in most developed nations, including the United States, where the rate is less than 1 per 100,000 men per year. Some studies suggest an association between human papillomavirus (HPV) infection and penile cancer.[<a class="bk_pop" href="#CDR0000062897_rl_1_2">2</a>-<a class="bk_pop" href="#CDR0000062897_rl_1_5">5</a>] Observational studies have shown a lower prevalence of penile HPV in men who have been circumcised (odds ratio, 0.37; 95% confidence interval, 0.16–0.85).[<a class="bk_pop" href="#CDR0000062897_rl_1_6">6</a>] Some, but not all, observational studies also suggest that male newborn circumcision is associated with a decreased risk of penile cancer.[<a class="bk_pop" href="#CDR0000062897_rl_1_7">7</a>,<a class="bk_pop" href="#CDR0000062897_rl_1_8">8</a>] According to published data, if the relationship is causal, the number needed to treat was about 909 circumcisions to prevent a single case of invasive penile cancer.[<a class="bk_pop" href="#CDR0000062897_rl_1_9">9</a>]</p></div><div id="CDR0000062897__198"><h3>Treatment Overview</h3><p id="CDR0000062897__199">When diagnosed early (<a href="#CDR0000062897__122">stage 0</a>, <a href="#CDR0000062897__39">stage I</a>, and <a href="#CDR0000062897__51">stage II</a>), penile cancer is highly curable.
|
|
Curability decreases sharply for <a href="#CDR0000062897__58">stage III</a> and <a href="#CDR0000062897__69">stage IV</a>. Because of the rarity of
|
|
this cancer in the United States, clinical trials specifically for penile
|
|
cancer are infrequent. Patients with stage III and stage IV cancer can be candidates
|
|
for phase I and phase II clinical trials testing new drugs, biologicals, or surgical
|
|
techniques to improve local control and distant metastases.
|
|
</p><p id="CDR0000062897__200">The selection of treatment depends on the following:[<a class="bk_pop" href="#CDR0000062897_rl_1_10">10</a>,<a class="bk_pop" href="#CDR0000062897_rl_1_11">11</a>]</p><ul id="CDR0000062897__201"><li class="half_rhythm"><div>Size.</div></li><li class="half_rhythm"><div>Location.</div></li><li class="half_rhythm"><div>Invasiveness.</div></li><li class="half_rhythm"><div>Stage of the tumor.</div></li></ul></div><div id="CDR0000062897_rl_1"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_1_1">American Cancer Society: Cancer Facts and Figures 2018. Atlanta, Ga: American Cancer Society, 2018. <a href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">Available online</a>. Last accessed April 27, 2018.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_2">Del Mistro A, Chieco Bianchi L: HPV-related neoplasias in HIV-infected individuals. Eur J Cancer 37 (10): 1227-35, 2001. [<a href="https://pubmed.ncbi.nlm.nih.gov/11423255" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11423255</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_3">Griffiths TR, Mellon JK: Human papillomavirus and urological tumours: I. Basic science and role in penile cancer. BJU Int 84 (5): 579-86, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10510097" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10510097</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_4">Poblet E, Alfaro L, Fernander-Segoviano P, et al.: Human papillomavirus-associated penile squamous cell carcinoma in HIV-positive patients. Am J Surg Pathol 23 (9): 1119-23, 1999. [<a href="https://pubmed.ncbi.nlm.nih.gov/10478673" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10478673</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_5">Frisch M, van den Brule AJ, Jiwa NM, et al.: HPV-16-positive anal and penile carcinomas in a young man--anogenital 'field effect' in the immunosuppressed male? Scand J Infect Dis 28 (6): 629-32, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/9060069" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9060069</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_6">Castellsagué X, Bosch FX, Muñoz N, et al.: Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med 346 (15): 1105-12, 2002. [<a href="https://pubmed.ncbi.nlm.nih.gov/11948269" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11948269</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_7">Schoen EJ, Oehrli M, Colby C, et al.: The highly protective effect of newborn circumcision against invasive penile cancer. Pediatrics 105 (3): E36, 2000. [<a href="https://pubmed.ncbi.nlm.nih.gov/10699138" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10699138</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_8">Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society. CMAJ 154 (6): 769-80, 1996. [<a href="/pmc/articles/PMC1487803/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1487803</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/8634956" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8634956</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_9">Christakis DA, Harvey E, Zerr DM, et al.: A trade-off analysis of routine newborn circumcision. Pediatrics 105 (1 Pt 3): 246-9, 2000. [<a href="https://pubmed.ncbi.nlm.nih.gov/10617731" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10617731</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_10">Trabulsi DJ, Gomella LG: Cancer of the urethra and penis. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1272-79.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_1_11">Chao KS, Perez CA: Penis and male urethra. In: Perez CA, Brady LW, eds.: Principles and Practice of Radiation Oncology. 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers, 1998, pp 1717-1732.</div></li></ol></div></div><div id="CDR0000062897__4"><h2 id="_CDR0000062897__4_">Cellular Classification of Penile Cancer</h2><p id="CDR0000062897__5">Virtually all penile carcinomas are of squamous cell origin and include the following subtypes:
|
|
</p><ul id="CDR0000062897__105"><li class="half_rhythm"><div>Verrucous carcinoma.[<a class="bk_pop" href="#CDR0000062897_rl_4_1">1</a>]</div></li><li class="half_rhythm"><div> Warty carcinoma (verruciform).[<a class="bk_pop" href="#CDR0000062897_rl_4_2">2</a>]</div></li><li class="half_rhythm"><div>Basaloid carcinoma.[<a class="bk_pop" href="#CDR0000062897_rl_4_3">3</a>] </div></li></ul><p id="CDR0000062897__130">Although they are less common subtypes, warty carcinoma and basaloid carcinoma appear to be more highly associated with human papillomaviruses (HPV), particularly HPV 16, than typical squamous cell carcinoma or verrucous carcinoma of the penis.[<a class="bk_pop" href="#CDR0000062897_rl_4_3">3</a>-<a class="bk_pop" href="#CDR0000062897_rl_4_5">5</a>] </p><p id="CDR0000062897__106">In addition, neuroendocrine carcinomas can also be seen.[<a class="bk_pop" href="#CDR0000062897_rl_4_6">6</a>]</p><div id="CDR0000062897_rl_4"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_4_1">Schwartz RA: Verrucous carcinoma of the skin and mucosa. J Am Acad Dermatol 32 (1): 1-21; quiz 22-4, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7822496" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7822496</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_4_2">Bezerra AL, Lopes A, Landman G, et al.: Clinicopathologic features and human papillomavirus dna prevalence of warty and squamous cell carcinoma of the penis. Am J Surg Pathol 25 (5): 673-8, 2001. [<a href="https://pubmed.ncbi.nlm.nih.gov/11342782" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11342782</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_4_3">Cubilla AL, Reuter VE, Gregoire L, et al.: Basaloid squamous cell carcinoma: a distinctive human papilloma virus-related penile neoplasm: a report of 20 cases. Am J Surg Pathol 22 (6): 755-61, 1998. [<a href="https://pubmed.ncbi.nlm.nih.gov/9630184" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9630184</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_4_4">Gregoire L, Cubilla AL, Reuter VE, et al.: Preferential association of human papillomavirus with high-grade histologic variants of penile-invasive squamous cell carcinoma. J Natl Cancer Inst 87 (22): 1705-9, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7473819" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7473819</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_4_5">Rubin MA, Kleter B, Zhou M, et al.: Detection and typing of human papillomavirus DNA in penile carcinoma: evidence for multiple independent pathways of penile carcinogenesis. Am J Pathol 159 (4): 1211-8, 2001. [<a href="/pmc/articles/PMC1850485/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1850485</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11583947" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11583947</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_4_6">Vadmal MS, Steckel J, Teichberg S, et al.: Primary neuroendocrine carcinoma of the penile urethra. J Urol 157 (3): 956-7, 1997. [<a href="https://pubmed.ncbi.nlm.nih.gov/9072615" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9072615</span></a>]</div></li></ol></div></div><div id="CDR0000062897__6"><h2 id="_CDR0000062897__6_">Stage Information for Penile Cancer</h2><p id="CDR0000062897__211"><i>Note: The American Joint Committee on Cancer (AJCC) has published the 8<sup>th</sup> edition of the AJCC Cancer Staging Manual, which includes revisions to the staging for this disease. Implementation of the 8<sup>th</sup> edition began in January 2018. The PDQ Adult Treatment Editorial Board, which maintains this summary, is reviewing the revised staging and will make appropriate changes as needed.</i></p><div id="CDR0000062897__163"><h3>Definitions of TNM</h3><p id="CDR0000062897__179">The AJCC has designated staging by TNM
|
|
classification to define penile cancer.[<a class="bk_pop" href="#CDR0000062897_rl_6_1">1</a>]</p><div id="CDR0000062897__164" class="table"><h3><span class="title">Table 1. Primary Tumor (T)<sup>a</sup></span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK65943.5/table/CDR0000062897__164/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000062897__164_lrgtbl__"><table class="no_margin"><tbody><tr><td colspan="1" rowspan="1" style="vertical-align:top;">TX</td><td colspan="1" rowspan="1" style="vertical-align:top;">Primary tumor cannot be assessed.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T0</td><td colspan="1" rowspan="1" style="vertical-align:top;">No evidence of primary tumor.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Tis</td><td colspan="1" rowspan="1" style="vertical-align:top;">Carcinoma <i>in situ</i>.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Ta</td><td colspan="1" rowspan="1" style="vertical-align:top;">Noninvasive verrucous carcinoma.<sup>b</sup></td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T1a</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tumor invades subepithelial connective tissue without lymph vascular invasion and is not poorly differentiated (i.e., grade 3–4).</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T1b</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tumor invades subepithelial connective tissue with lymph vascular invasion or is poorly differentiated.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T2</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tumor invades corpus spongiosum or cavernosum.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T3</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tumor invades urethra.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T4</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tumor invades other adjacent structures.</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin"><sup>a</sup>Reprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</p></div></dd><dt></dt><dd><div><p class="no_margin"><sup>b</sup>Broad pushing penetration (invasion) is permitted; destructive invasion is against this diagnosis.</p></div></dd></dl></div></div></div><div id="CDR0000062897__165" class="table"><h3><span class="title">Table 2. Regional Lymph Nodes (N)<sup>a</sup></span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK65943.5/table/CDR0000062897__165/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000062897__165_lrgtbl__"><table class="no_margin"><tbody><tr><td colspan="2" rowspan="1" style="text-align:center;vertical-align:top;"><i>Clinical Stage Definition</i><sup>b</sup></td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">cNX</td><td colspan="1" rowspan="1" style="vertical-align:top;">Regional lymph nodes cannot be assessed.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">cN0</td><td colspan="1" rowspan="1" style="vertical-align:top;">No palpable or visibly enlarged inguinal lymph nodes.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">cN1</td><td colspan="1" rowspan="1" style="vertical-align:top;">Palpable mobile unilateral inguinal lymph node.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">cN2</td><td colspan="1" rowspan="1" style="vertical-align:top;">Palpable mobile multiple or bilateral inguinal lymph nodes.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">cN3</td><td colspan="1" rowspan="1" style="vertical-align:top;">Palpable fixed inguinal nodal mass or pelvic lymphadenopathy unilateral or bilateral.</td></tr><tr><td colspan="2" rowspan="1" style="text-align:center;vertical-align:top;"><i>Pathologic Stage Definition</i><sup>c</sup></td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">pNX</td><td colspan="1" rowspan="1" style="vertical-align:top;">Regional lymph nodes cannot be assessed.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">pN0</td><td colspan="1" rowspan="1" style="vertical-align:top;">No regional lymph node metastasis.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">pN1</td><td colspan="1" rowspan="1" style="vertical-align:top;">Metastasis in a single inguinal lymph node.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">pN2</td><td colspan="1" rowspan="1" style="vertical-align:top;">Metastases in multiple or bilateral inguinal lymph nodes.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">pN3</td><td colspan="1" rowspan="1" style="vertical-align:top;">Extranodal extension of lymph node metastasis or pelvic lymph node(s) unilateral or bilateral.</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin"><sup>a</sup>Reprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</p></div></dd><dt></dt><dd><div><p class="no_margin"><sup>b</sup>Clinical stage definition based on palpation, imaging.</p></div></dd><dt></dt><dd><div><p class="no_margin"><sup>c</sup>Pathologic stage definition based on biopsy or surgical excision.</p></div></dd></dl></div></div></div><div id="CDR0000062897__166" class="table"><h3><span class="title">Table 3. Distant Metastasis (M)<sup>a</sup></span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK65943.5/table/CDR0000062897__166/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000062897__166_lrgtbl__"><table class="no_margin"><tbody><tr><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td><td colspan="1" rowspan="1" style="vertical-align:top;">No distant metastasis.</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">M1</td><td colspan="1" rowspan="1" style="vertical-align:top;">Distant metastasis.<sup>b</sup></td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin"><sup>a</sup>Reprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</p></div></dd><dt></dt><dd><div><p class="no_margin"><sup>b</sup>Lymph node metastasis outside of the true pelvis in addition to visceral or bone sites.</p></div></dd></dl></div></div></div><p id="CDR0000062897__167"><b>Additional Descriptor. </b>The m suffix indicates the presence of multiple primary tumors and is recorded in parentheses – e.g., pTa (m) N0M0.[<a class="bk_pop" href="#CDR0000062897_rl_6_1">1</a>]</p><div id="CDR0000062897__168" class="table"><h3><span class="title">Table 4. Anatomic Stage/Prognostic Groups<sup>a</sup></span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK65943.5/table/CDR0000062897__168/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__CDR0000062897__168_lrgtbl__"><table class="no_margin"><thead><tr><th colspan="1" rowspan="1" style="text-align:center;vertical-align:top;">Stage</th><th colspan="1" rowspan="1" style="text-align:center;vertical-align:top;">T</th><th colspan="1" rowspan="1" style="text-align:center;vertical-align:top;">N</th><th colspan="1" rowspan="1" style="text-align:center;vertical-align:top;">M</th></tr></thead><tbody><tr><td colspan="1" rowspan="2" style="vertical-align:top;">0</td><td colspan="1" rowspan="1" style="vertical-align:top;">Tis</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Ta</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">I</td><td colspan="1" rowspan="1" style="vertical-align:top;">T1a</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="3" style="vertical-align:top;">II</td><td colspan="1" rowspan="1" style="vertical-align:top;">T1b</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T2</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">T3</td><td colspan="1" rowspan="1" style="vertical-align:top;">N0</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">IIIa</td><td colspan="1" rowspan="1" style="vertical-align:top;">T1–3</td><td colspan="1" rowspan="1" style="vertical-align:top;">N1</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">IIIb</td><td colspan="1" rowspan="1" style="vertical-align:top;">T1–3</td><td colspan="1" rowspan="1" style="vertical-align:top;">N2</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="3" style="vertical-align:top;"> IV</td><td colspan="1" rowspan="1" style="vertical-align:top;">T4</td><td colspan="1" rowspan="1" style="vertical-align:top;">Any N</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Any T</td><td colspan="1" rowspan="1" style="vertical-align:top;">N3</td><td colspan="1" rowspan="1" style="vertical-align:top;">M0</td></tr><tr><td colspan="1" rowspan="1" style="vertical-align:top;">Any T</td><td colspan="1" rowspan="1" style="vertical-align:top;">Any N</td><td colspan="1" rowspan="1" style="vertical-align:top;">M1</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin"><sup>a</sup>Reprinted with permission from AJCC: Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</p></div></dd></dl></div></div></div></div><div id="CDR0000062897_rl_6"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_6_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li></ol></div></div><div id="CDR0000062897__122"><h2 id="_CDR0000062897__122_">Stage 0 Penile Cancer</h2><p id="CDR0000062897__184"><b>Stage 0 penile cancer is defined by the following TNM classifications:[<a class="bk_pop" href="#CDR0000062897_rl_122_1">1</a>]</b></p><ul id="CDR0000062897__124"><li class="half_rhythm"><div>Tis, N0, M0</div></li><li class="half_rhythm"><div>Ta, N0, M0</div></li></ul><p id="CDR0000062897__125">Carcinoma <i>in situ</i> of the penis is referred to as erythroplasia of Queyrat when it occurs on the glans, and Bowen disease when it occurs on the penile shaft. These precursor lesions progress to invasive squamous cell carcinoma in 5% to 15% of cases. In case series studies, human papillomavirus DNA has been detected in the majority of these lesions.[<a class="bk_pop" href="#CDR0000062897_rl_122_2">2</a>,<a class="bk_pop" href="#CDR0000062897_rl_122_3">3</a>] With no data from clinical trials in this disease stage, treatment recommendations are largely based on case reports and case series involving limited numbers of patients.</p><p id="CDR0000062897__126"><b>Treatment options:
|
|
</b></p><ol id="CDR0000062897__127"><li class="half_rhythm"><div>Surgical excision can result in scarring, deformity, and impaired function. To minimize these effects, Mohs micrographic surgery, which involves the excision of successive horizontal layers of tissue with microscopic examination of each layer in frozen section, has been used in patients with <i>in situ</i> and invasive penile cancers.[<a class="bk_pop" href="#CDR0000062897_rl_122_4">4</a>,<a class="bk_pop" href="#CDR0000062897_rl_122_5">5</a>][<a href="/books/n/pdqcis/glossary_loe/def-item/glossary_loe_CDR0000587991/" class="def">Level of evidence: 3iiiDiv</a>]</div></li><li class="half_rhythm"><div>Topical application of 5-fluorouracil cream has been reported to be effective in cases of erythroplasia of Queyrat [<a class="bk_pop" href="#CDR0000062897_rl_122_6">6</a>] and Bowen disease.[<a class="bk_pop" href="#CDR0000062897_rl_122_7">7</a>][<a href="/books/n/pdqcis/glossary_loe/def-item/glossary_loe_CDR0000587991/" class="def">Level of evidence: 3iiiDiv</a>]</div></li><li class="half_rhythm"><div> Imiquimod 5% cream is a topical immune response modifier that has been reported to be effective with good cosmetic and functional results.[<a class="bk_pop" href="#CDR0000062897_rl_122_8">8</a>-<a class="bk_pop" href="#CDR0000062897_rl_122_10">10</a>][<a href="/books/n/pdqcis/glossary_loe/def-item/glossary_loe_CDR0000587991/" class="def">Level of evidence: 3iiiDiv</a>]</div></li><li class="half_rhythm"><div>Laser therapy with Nd:YAG or CO<sub>2</sub> lasers has also been reported to result in excellent cosmetic results.[<a class="bk_pop" href="#CDR0000062897_rl_122_11">11</a>][<a href="/books/n/pdqcis/glossary_loe/def-item/glossary_loe_CDR0000587991/" class="def">Level of evidence: 3iiiDiv</a>]</div></li><li class="half_rhythm"><div>Cryosurgery has been reported to result in good cosmetic results in patients with erythroplasia of Queyrat and verrucous penile carcinoma.[<a class="bk_pop" href="#CDR0000062897_rl_122_12">12</a>,<a class="bk_pop" href="#CDR0000062897_rl_122_13">13</a>][<a href="/books/n/pdqcis/glossary_loe/def-item/glossary_loe_CDR0000587991/" class="def">Level of evidence: 3iiiDiv</a>]</div></li></ol><div id="CDR0000062897__TrialSearch_122_sid_4"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_122_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_122"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_122_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_2">Cupp MR, Malek RS, Goellner JR, et al.: The detection of human papillomavirus deoxyribonucleic acid in intraepithelial, in situ, verrucous and invasive carcinoma of the penis. J Urol 154 (3): 1024-9, 1995. [<a href="https://pubmed.ncbi.nlm.nih.gov/7637047" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7637047</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_3">Rubin MA, Kleter B, Zhou M, et al.: Detection and typing of human papillomavirus DNA in penile carcinoma: evidence for multiple independent pathways of penile carcinogenesis. Am J Pathol 159 (4): 1211-8, 2001. [<a href="/pmc/articles/PMC1850485/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1850485</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11583947" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11583947</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_4">Mohs FE, Snow SN, Messing EM, et al.: Microscopically controlled surgery in the treatment of carcinoma of the penis. J Urol 133 (6): 961-6, 1985. [<a href="https://pubmed.ncbi.nlm.nih.gov/3999220" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3999220</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_5">Moritz DL, Lynch WS: Extensive Bowen's disease of the penile shaft treated with fresh tissue Mohs micrographic surgery in two separate operations. J Dermatol Surg Oncol 17 (4): 374-8, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/2040751" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2040751</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_6">Goette DK, Carson TE: Erythroplasia of Queyrat: treatment with topical 5-fluorouracil. Cancer 38 (4): 1498-502, 1976. [<a href="https://pubmed.ncbi.nlm.nih.gov/991073" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 991073</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_7">Tolia BM, Castro VL, Mouded IM, et al.: Bowen's disease of shaft of penis. Successful treatment with 5-fluorouracil. Urology 7 (6): 617-9, 1976. [<a href="https://pubmed.ncbi.nlm.nih.gov/936382" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 936382</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_8">Danielsen AG, Sand C, Weismann K: Treatment of Bowen's disease of the penis with imiquimod 5% cream. Clin Exp Dermatol 28 (Suppl 1): 7-9, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/14616803" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14616803</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_9">Micali G, Nasca MR, Tedeschi A: Topical treatment of intraepithelial penile carcinoma with imiquimod. Clin Exp Dermatol 28 (Suppl 1): 4-6, 2003. [<a href="https://pubmed.ncbi.nlm.nih.gov/14616802" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14616802</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_10">Schroeder TL, Sengelmann RD: Squamous cell carcinoma in situ of the penis successfully treated with imiquimod 5% cream. J Am Acad Dermatol 46 (4): 545-8, 2002. [<a href="https://pubmed.ncbi.nlm.nih.gov/11907505" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11907505</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_11">van Bezooijen BP, Horenblas S, Meinhardt W, et al.: Laser therapy for carcinoma in situ of the penis. J Urol 166 (5): 1670-1, 2001. [<a href="https://pubmed.ncbi.nlm.nih.gov/11586199" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11586199</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_12">Michelman FA, Filho AC, Moraes AM: Verrucous carcinoma of the penis treated with cryosurgery. J Urol 168 (3): 1096-7, 2002. [<a href="https://pubmed.ncbi.nlm.nih.gov/12187233" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12187233</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_122_13">Sonnex TS, Ralfs IG, Plaza de Lanza M, et al.: Treatment of erythroplasia of Queyrat with liquid nitrogen cryosurgery. Br J Dermatol 106 (5): 581-4, 1982. [<a href="https://pubmed.ncbi.nlm.nih.gov/7073983" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7073983</span></a>]</div></li></ol></div></div><div id="CDR0000062897__39"><h2 id="_CDR0000062897__39_">Stage I Penile Cancer</h2><p id="CDR0000062897__185"><b>Stage I penile cancer is defined by the following TNM classification:[<a class="bk_pop" href="#CDR0000062897_rl_39_1">1</a>]</b></p><ul id="CDR0000062897__87"><li class="half_rhythm"><div>T1a, N0, M0</div></li></ul><p id="CDR0000062897__41">Stage I penile cancer is curable.[<a class="bk_pop" href="#CDR0000062897_rl_39_2">2</a>]
|
|
</p><p id="CDR0000062897__42"><b>Standard treatment options:
|
|
</b></p><ol id="CDR0000062897__79"><li class="half_rhythm"><div>For lesions limited to the foreskin, wide local excision with circumcision may
|
|
be adequate therapy for control.
|
|
</div></li><li class="half_rhythm"><div>For infiltrating tumors of the glans with or without involvement of the
|
|
adjacent skin, the choice of therapy is dictated by tumor size, extent of
|
|
infiltration, and degree of tumor destruction of normal tissue. Equivalent
|
|
therapeutic options include:
|
|
<ul id="CDR0000062897__47"><li class="half_rhythm"><div>Penile amputation.[<a class="bk_pop" href="#CDR0000062897_rl_39_3">3</a>]
|
|
</div></li><li class="half_rhythm"><div>Radiation therapy (i.e., external-beam radiation therapy and brachytherapy).[<a class="bk_pop" href="#CDR0000062897_rl_39_4">4</a>,<a class="bk_pop" href="#CDR0000062897_rl_39_5">5</a>]
|
|
</div></li><li class="half_rhythm"><div>Microscopically controlled surgery.[<a class="bk_pop" href="#CDR0000062897_rl_39_6">6</a>]
|
|
</div></li></ul></div></li></ol><p id="CDR0000062897__48"><b>Treatment options under clinical evaluation:
|
|
</b></p><ul id="CDR0000062897__80"><li class="half_rhythm"><div>Nd:YAG laser therapy has offered excellent control/cure with preservation of
|
|
cosmetic appearance and sexual function.[<a class="bk_pop" href="#CDR0000062897_rl_39_7">7</a>,<a class="bk_pop" href="#CDR0000062897_rl_39_8">8</a>]
|
|
</div></li></ul><p id="CDR0000062897__50">Because of the high incidence of microscopic node metastases, elective
|
|
adjunctive inguinal dissection of clinically uninvolved (negative) lymph nodes
|
|
in conjunction with amputation is often used for patients with poorly
|
|
differentiated tumors. Lymphadenectomy can carry substantial
|
|
morbidity, such as infection, skin necrosis, wound breakdown, chronic edema,
|
|
and even a low, but finite, mortality rate. The impact of prophylactic
|
|
lymphadenectomy on survival is not known. For these reasons, opinions vary on its use.[<a class="bk_pop" href="#CDR0000062897_rl_39_9">9</a>-<a class="bk_pop" href="#CDR0000062897_rl_39_12">12</a>]
|
|
</p><div id="CDR0000062897__TrialSearch_39_sid_5"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_39_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_39"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_39_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_2">Harty JI, Catalona WJ: Carcinoma of the penis. In: Javadpour N, ed.: Principles and Management of Urologic Cancer. 2nd ed. Baltimore, Md: Williams and Wilkins, 1983, pp 581-597.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_3">Lynch DF, Pettaway CA: Tumors of the penis. In: Walsh PC, Retik AB, Vaughan ED, et al., eds.: Campbell's Urology. 8th ed. Philadelphia: Saunders, 2002, pp 2945-2947.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_4">Chao KS, Perez CA: Penis and male urethra. In: Perez CA, Brady LW, eds.: Principles and Practice of Radiation Oncology. 3rd ed. Philadelphia, Pa: Lippincott-Raven Publishers, 1998, pp 1717-1732.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_5">McLean M, Akl AM, Warde P, et al.: The results of primary radiation therapy in the management of squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys 25 (4): 623-8, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8454480" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8454480</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_6">Mohs FE, Snow SN, Messing EM, et al.: Microscopically controlled surgery in the treatment of carcinoma of the penis. J Urol 133 (6): 961-6, 1985. [<a href="https://pubmed.ncbi.nlm.nih.gov/3999220" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3999220</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_7">Smith JA Jr.: Lasers in clinical urologic surgery. In: Dixon JA, ed.: Surgical Application of Lasers. 2nd ed. Chicago, Ill: Year Book Medical Publishers, Inc., 1987, pp 218-237.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_8">Horenblas S, van Tinteren H, Delemarre JF, et al.: Squamous cell carcinoma of the penis. II. Treatment of the primary tumor. J Urol 147 (6): 1533-8, 1992. [<a href="https://pubmed.ncbi.nlm.nih.gov/1593683" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1593683</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_9">Theodorescu D, Russo P, Zhang ZF, et al.: Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 155 (5): 1626-31, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8627839" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8627839</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_10">Lindegaard JC, Nielsen OS, Lundbeck FA, et al.: A retrospective analysis of 82 cases of cancer of the penis. Br J Urol 77 (6): 883-90, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8705227" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8705227</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_11">Ornellas AA, Seixas AL, Marota A, et al.: Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 151 (5): 1244-9, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7512656" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7512656</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_39_12">Young MJ, Reda DJ, Waters WB: Penile carcinoma: a twenty-five-year experience. Urology 38 (6): 529-32, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1746081" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1746081</span></a>]</div></li></ol></div></div><div id="CDR0000062897__51"><h2 id="_CDR0000062897__51_">Stage II Penile Cancer</h2><p id="CDR0000062897__186"><b>Stage II penile cancer is defined by the following TNM classifications:[<a class="bk_pop" href="#CDR0000062897_rl_51_1">1</a>]</b></p><ul id="CDR0000062897__88"><li class="half_rhythm"><div>T1b, N0, M0</div></li><li class="half_rhythm"><div>T2, N0, M0</div></li><li class="half_rhythm"><div>T3, N0, M0</div></li></ul><p id="CDR0000062897__53"><b>Standard treatment options:
|
|
</b></p><ul id="CDR0000062897__81"><li class="half_rhythm"><div>Stage II penile cancer is most frequently managed by penile amputation for
|
|
local control. Whether the amputation is partial, total, or radical will
|
|
depend on the extent and location of the neoplasm. External-beam radiation therapy and brachytherapy with
|
|
surgical salvage are alternative approaches.[<a class="bk_pop" href="#CDR0000062897_rl_51_2">2</a>-<a class="bk_pop" href="#CDR0000062897_rl_51_6">6</a>]</div></li></ul><p id="CDR0000062897__55"><b>Treatment options under clinical evaluation:
|
|
</b></p><ul id="CDR0000062897__82"><li class="half_rhythm"><div>Nd:YAG laser therapy has been used to preserve the penis in selected patients
|
|
with small lesions.[<a class="bk_pop" href="#CDR0000062897_rl_51_7">7</a>]</div></li></ul><p id="CDR0000062897__57">Because of the high incidence of microscopic node metastases, elective
|
|
adjunctive dissection of clinically uninvolved (negative) lymph nodes in
|
|
conjunction with amputation is often used for patients with poorly
|
|
differentiated tumors. Lymphadenectomy, can carry substantial
|
|
morbidity, such as infection, skin necrosis, wound breakdown, chronic edema,
|
|
and even a low, but finite, mortality rate. The impact of prophylactic
|
|
lymphadenectomy on survival is not known.[<a class="bk_pop" href="#CDR0000062897_rl_51_8">8</a>-<a class="bk_pop" href="#CDR0000062897_rl_51_11">11</a>]
|
|
</p><p id="CDR0000062897__142">To reduce the morbidity associated with prophylactic lymphadenectomy, dynamic sentinel node biopsy is being used in patients with stage T2 clinically node-negative penile cancer. One retrospective single-institution study of 22 patients reported a false-negative rate of 11%.[<a class="bk_pop" href="#CDR0000062897_rl_51_12">12</a>]</p><div id="CDR0000062897__TrialSearch_51_sid_6"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_51_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_51"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_51_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_2">Harty JI, Catalona WJ: Carcinoma of the penis. In: Javadpour N, ed.: Principles and Management of Urologic Cancer. 2nd ed. Baltimore, Md: Williams and Wilkins, 1983, pp 581-597.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_3">Schellhammer PF, Spaulding JT: Carcinoma of the penis. In: Paulson DF, ed.: Genitourinary Surgery. Vol. 2. New York: Churchill Livingston, 1984, pp 629-654.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_4">Johnson DE, Lo RK: Tumors of the penis, urethra, and scrotum. In: deKernion JB, Paulson DF, eds.: Genitourinary Cancer Management. Philadelphia, Pa: Lea and Febiger, 1987, pp 219-258.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_5">McLean M, Akl AM, Warde P, et al.: The results of primary radiation therapy in the management of squamous cell carcinoma of the penis. Int J Radiat Oncol Biol Phys 25 (4): 623-8, 1993. [<a href="https://pubmed.ncbi.nlm.nih.gov/8454480" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8454480</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_6">Crook JM, Jezioranski J, Grimard L, et al.: Penile brachytherapy: results for 49 patients. Int J Radiat Oncol Biol Phys 62 (2): 460-7, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/15890588" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15890588</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_7">Horenblas S, van Tinteren H, Delemarre JF, et al.: Squamous cell carcinoma of the penis. II. Treatment of the primary tumor. J Urol 147 (6): 1533-8, 1992. [<a href="https://pubmed.ncbi.nlm.nih.gov/1593683" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1593683</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_8">Theodorescu D, Russo P, Zhang ZF, et al.: Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 155 (5): 1626-31, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8627839" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8627839</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_9">Lindegaard JC, Nielsen OS, Lundbeck FA, et al.: A retrospective analysis of 82 cases of cancer of the penis. Br J Urol 77 (6): 883-90, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8705227" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8705227</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_10">Ornellas AA, Seixas AL, Marota A, et al.: Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 151 (5): 1244-9, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7512656" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7512656</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_11">Young MJ, Reda DJ, Waters WB: Penile carcinoma: a twenty-five-year experience. Urology 38 (6): 529-32, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1746081" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1746081</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_51_12">Perdonà S, Autorino R, De Sio M, et al.: Dynamic sentinel node biopsy in clinically node-negative penile cancer versus radical inguinal lymphadenectomy: a comparative study. Urology 66 (6): 1282-6, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/16360457" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16360457</span></a>]</div></li></ol></div></div><div id="CDR0000062897__58"><h2 id="_CDR0000062897__58_">Stage III Penile Cancer</h2><p id="CDR0000062897__187"><b>Stage III penile cancer is defined by the following TNM classifications:[<a class="bk_pop" href="#CDR0000062897_rl_58_1">1</a>]</b></p><ul id="CDR0000062897__89"><li class="half_rhythm"><div>T1–3, N1, M0</div></li><li class="half_rhythm"><div>T1–3, N2, M0</div></li></ul><p id="CDR0000062897__60">Inguinal adenopathy in patients with penile cancer is common but may be the
|
|
result of infection rather than neoplasm. If palpable enlarged lymph nodes
|
|
exist 3 or more weeks after removal of the infected primary lesion and completion of a
|
|
course of antibiotic therapy, bilateral inguinal lymph node dissection should
|
|
be performed.
|
|
</p><p id="CDR0000062897__61">In cases of proven regional inguinal lymph node metastasis without evidence of
|
|
distant spread, bilateral ilioinguinal dissection is the treatment of
|
|
choice.[<a class="bk_pop" href="#CDR0000062897_rl_58_2">2</a>-<a class="bk_pop" href="#CDR0000062897_rl_58_5">5</a>] Since many patients with positive lymph nodes are not
|
|
cured, clinical trials may be appropriate.
|
|
</p><p id="CDR0000062897__62"><b>Standard treatment options:</b>
|
|
</p><ol id="CDR0000062897__83"><li class="half_rhythm"><div>Clinically evident regional lymph node metastasis without evidence of
|
|
distant spread is an indication for bilateral ilioinguinal lymph node
|
|
dissection after penile amputation.[<a class="bk_pop" href="#CDR0000062897_rl_58_6">6</a>]</div></li><li class="half_rhythm"><div>Radiation therapy may be considered as an alternative to lymph node
|
|
dissection in patients who are not surgical candidates.</div></li><li class="half_rhythm"><div>Postoperative radiation therapy may decrease incidence of inguinal recurrences.</div></li></ol><p id="CDR0000062897__66"><b>Treatment options under clinical evaluation:</b>
|
|
</p><ul id="CDR0000062897__84"><li class="half_rhythm"><div>Clinical trials using radiosensitizers or cytotoxic drugs are appropriate. A
|
|
combination of vincristine, bleomycin, and methotrexate has been effective as
|
|
both neoadjuvant and adjuvant therapy.[<a class="bk_pop" href="#CDR0000062897_rl_58_7">7</a>] Cisplatin (100 mg/m²) as neoadjuvant therapy plus continuous-infusion 5-fluorouracil has also
|
|
been shown to be effective.[<a class="bk_pop" href="#CDR0000062897_rl_58_6">6</a>] Single-agent cisplatin (50 mg/m<sup>2</sup>) was tested in a large trial and was found to be ineffective.[<a class="bk_pop" href="#CDR0000062897_rl_58_8">8</a>]</div></li></ul><p id="CDR0000062897__68">Because of the high incidence of microscopic node metastases, adjunctive
|
|
inguinal dissection of clinically uninvolved (negative) lymph nodes in
|
|
conjunction with amputation is often used for patients with poorly
|
|
differentiated tumors. Lymphadenectomy can carry substantial
|
|
morbidity, such as infection, skin necrosis, wound breakdown, chronic edema,
|
|
and even a low, but finite, mortality rate. The impact of prophylactic
|
|
lymphadenectomy on survival is not known. [<a class="bk_pop" href="#CDR0000062897_rl_58_3">3</a>,<a class="bk_pop" href="#CDR0000062897_rl_58_4">4</a>,<a class="bk_pop" href="#CDR0000062897_rl_58_9">9</a>,<a class="bk_pop" href="#CDR0000062897_rl_58_10">10</a>]
|
|
</p><p id="CDR0000062897__146">To reduce the morbidity associated with prophylactic lymphadenectomy, dynamic sentinel node biopsy is being used in patients with stage T2 and stage T3 clinically node-negative penile cancer. One retrospective single-institution study of 22 patients reported a false-negative rate of 11%.[<a class="bk_pop" href="#CDR0000062897_rl_58_11">11</a>]</p><div id="CDR0000062897__TrialSearch_58_sid_7"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_58_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_58"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_58_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_2">Harty JI, Catalona WJ: Carcinoma of the penis. In: Javadpour N, ed.: Principles and Management of Urologic Cancer. 2nd ed. Baltimore, Md: Williams and Wilkins, 1983, pp 581-597.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_3">Theodorescu D, Russo P, Zhang ZF, et al.: Outcomes of initial surveillance of invasive squamous cell carcinoma of the penis and negative nodes. J Urol 155 (5): 1626-31, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8627839" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8627839</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_4">Lindegaard JC, Nielsen OS, Lundbeck FA, et al.: A retrospective analysis of 82 cases of cancer of the penis. Br J Urol 77 (6): 883-90, 1996. [<a href="https://pubmed.ncbi.nlm.nih.gov/8705227" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8705227</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_5">Lynch DF, Pettaway CA: Tumors of the penis. In: Walsh PC, Retik AB, Vaughan ED, et al., eds.: Campbell's Urology. 8th ed. Philadelphia: Saunders, 2002, pp 2945-2947.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_6">Fisher HA, Barada JH, Horton J, et al.: Neoadjuvant therapy with cisplatin and 5-fluorouracil for stage III squamous cell carcinoma of the penis. [Abstract] J Urol 143(4 Suppl): A-653, 352A, 1990.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_7">Pizzocaro G, Piva L: Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27 (6b): 823-4, 1988. [<a href="https://pubmed.ncbi.nlm.nih.gov/2466471" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2466471</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_8">Gagliano RG, Blumenstein BA, Crawford ED, et al.: cis-Diamminedichloroplatinum in the treatment of advanced epidermoid carcinoma of the penis: a Southwest Oncology Group Study. J Urol 141 (1): 66-7, 1989. [<a href="https://pubmed.ncbi.nlm.nih.gov/2642312" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2642312</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_9">Ornellas AA, Seixas AL, Marota A, et al.: Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 151 (5): 1244-9, 1994. [<a href="https://pubmed.ncbi.nlm.nih.gov/7512656" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7512656</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_10">Young MJ, Reda DJ, Waters WB: Penile carcinoma: a twenty-five-year experience. Urology 38 (6): 529-32, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1746081" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1746081</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_58_11">Perdonà S, Autorino R, De Sio M, et al.: Dynamic sentinel node biopsy in clinically node-negative penile cancer versus radical inguinal lymphadenectomy: a comparative study. Urology 66 (6): 1282-6, 2005. [<a href="https://pubmed.ncbi.nlm.nih.gov/16360457" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16360457</span></a>]</div></li></ol></div></div><div id="CDR0000062897__69"><h2 id="_CDR0000062897__69_">Stage IV Penile Cancer</h2><p id="CDR0000062897__188"><b>Stage IV penile cancer is defined by the following TNM classifications:[<a class="bk_pop" href="#CDR0000062897_rl_69_1">1</a>]</b></p><ul id="CDR0000062897__90"><li class="half_rhythm"><div>T4, Any N, M0</div></li><li class="half_rhythm"><div>Any T, N3, M0</div></li><li class="half_rhythm"><div>Any T, Any N, M1</div></li></ul><p id="CDR0000062897__71">No standard treatment exists that is curative for patients with stage IV penile cancer.
|
|
Therapy is directed at palliation, which may be achieved either with surgery or
|
|
radiation therapy.
|
|
</p><p id="CDR0000062897__72"><b>Standard treatment options:</b>
|
|
</p><ol id="CDR0000062897__85"><li class="half_rhythm"><div>Palliative surgery may be considered for control of the local penile lesion
|
|
and even for the prevention of the necrosis, infection, and hemorrhage that
|
|
can result from neglected regional adenopathy.
|
|
</div></li><li class="half_rhythm"><div>Radiation therapy may be palliative for the primary tumor, regional adenopathy,
|
|
and bone metastases.
|
|
</div></li></ol><p id="CDR0000062897__75"><b>Treatment options under clinical evaluation:
|
|
</b></p><ul id="CDR0000062897__86"><li class="half_rhythm"><div>Clinical trials combining chemotherapy with palliative methods of local control
|
|
are appropriate for such patients (tested chemotherapeutic drugs with some
|
|
efficacy include vincristine, cisplatin, methotrexate, and bleomycin). The
|
|
combination of vincristine, bleomycin, and methotrexate has been effective both
|
|
as adjuvant and neoadjuvant therapy.[<a class="bk_pop" href="#CDR0000062897_rl_69_2">2</a>]</div></li></ul><div id="CDR0000062897__TrialSearch_69_sid_8"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_69_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_69"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_69_1">Penis. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 447-55.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_69_2">Pizzocaro G, Piva L: Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27 (6b): 823-4, 1988. [<a href="https://pubmed.ncbi.nlm.nih.gov/2466471" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2466471</span></a>]</div></li></ol></div></div><div id="CDR0000062897__77"><h2 id="_CDR0000062897__77_">Recurrent Penile Cancer</h2><p id="CDR0000062897__78">Locally recurrent disease can be approached by surgery or radiation therapy.
|
|
If the initial treatment of radiation therapy fails, patients are often salvaged by
|
|
penile amputation. Patients with nodal recurrences that are not controllable
|
|
by local measures are candidates for phase I and phase II clinical trials testing new
|
|
biologicals and chemotherapeutic agents.[<a class="bk_pop" href="#CDR0000062897_rl_77_1">1</a>-<a class="bk_pop" href="#CDR0000062897_rl_77_5">5</a>]</p><div id="CDR0000062897__TrialSearch_77_sid_9"><h3>Current Clinical Trials</h3><p id="CDR0000062897__TrialSearch_77_22">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/advanced-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">advanced clinical trial search</a> to find NCI-supported cancer clinical trials that are now enrolling patients. The search can be narrowed by location of the trial, type of treatment, name of the drug, and other criteria. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062897_rl_77"><h3>References</h3><ol><li><div class="bk_ref" id="CDR0000062897_rl_77_1">Pizzocaro G, Piva L: Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27 (6b): 823-4, 1988. [<a href="https://pubmed.ncbi.nlm.nih.gov/2466471" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2466471</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_77_2">Ahmed T, Sklaroff R, Yagoda A: Sequential trials of methotrexate, cisplatin and bleomycin for penile cancer. J Urol 132 (3): 465-8, 1984. [<a href="https://pubmed.ncbi.nlm.nih.gov/6206239" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6206239</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_77_3">Dexeus FH, Logothetis CJ, Sella A, et al.: Combination chemotherapy with methotrexate, bleomycin and cisplatin for advanced squamous cell carcinoma of the male genital tract. J Urol 146 (5): 1284-7, 1991. [<a href="https://pubmed.ncbi.nlm.nih.gov/1719241" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1719241</span></a>]</div></li><li><div class="bk_ref" id="CDR0000062897_rl_77_4">Fisher HA, Barada JH, Horton J, et al.: Neoadjuvant therapy with cisplatin and 5-fluorouracil for stage III squamous cell carcinoma of the penis. [Abstract] J Urol 143(4 Suppl): A-653, 352A, 1990.</div></li><li><div class="bk_ref" id="CDR0000062897_rl_77_5">Hussein AM, Benedetto P, Sridhar KS: Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas. Cancer 65 (3): 433-8, 1990. [<a href="https://pubmed.ncbi.nlm.nih.gov/2297633" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2297633</span></a>]</div></li></ol></div></div><div id="CDR0000062897__97"><h2 id="_CDR0000062897__97_">Changes to This Summary (01/30/2018)</h2><p id="CDR0000062897__98">The PDQ cancer information summaries are reviewed regularly and updated as
|
|
new information becomes available. This section describes the latest
|
|
changes made to this summary as of the date above.
|
|
</p><p id="CDR0000062897__209"><b><a href="#CDR0000062897__1">General Information About Penile Cancer</a></b></p><p id="CDR0000062897__210">Updated <a href="#CDR0000062897__131">statistics</a> with estimated new cases and deaths for 2018 (cited American Cancer Society as reference 1).</p><p id="CDR0000062897__212"><b><a href="#CDR0000062897__6">Stage Information for Penile Cancer</a></b></p><p id="CDR0000062897__213">Editorial changes were made to this section.</p><p id="CDR0000062897__disclaimerHP_3">This summary is written and maintained by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>, which is
|
|
editorially independent of NCI. The summary reflects an independent review of
|
|
the literature and does not represent a policy statement of NCI or NIH. More
|
|
information about summary policies and the role of the PDQ Editorial Boards in
|
|
maintaining the PDQ summaries can be found on the <a href="#CDR0000062897__AboutThis_1">About This PDQ Summary</a> and <a href="http://www.cancer.gov/publications/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ® - NCI's Comprehensive Cancer Database</a> pages.
|
|
</p></div><div id="CDR0000062897__AboutThis_1"><h2 id="_CDR0000062897__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062897__AboutThis_2"><h3>Purpose of This Summary</h3><p id="CDR0000062897__AboutThis_3">This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of penile cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.</p></div><div id="CDR0000062897__AboutThis_4"><h3>Reviewers and Updates</h3><p id="CDR0000062897__AboutThis_5">This summary is reviewed regularly and updated as necessary by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH).</p><p id="CDR0000062897__AboutThis_22"> Board members review recently published articles each month to determine whether an article should:</p><ul id="CDR0000062897__AboutThis_6"><li class="half_rhythm"><div>be discussed at a meeting,</div></li><li class="half_rhythm"><div>be cited with text, or</div></li><li class="half_rhythm"><div>replace or update an existing article that is already cited.</div></li></ul><p id="CDR0000062897__AboutThis_7">Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.</p><p>The lead reviewer for Penile Cancer Treatment is:</p><ul><li class="half_rhythm"><div>Franco M. Muggia, MD (New York University Medical Center)</div></li></ul><p id="CDR0000062897__AboutThis_9">Any comments or questions about the summary content should be submitted to Cancer.gov through the NCI website's <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries.</p></div><div id="CDR0000062897__AboutThis_10"><h3>Levels of Evidence</h3><p id="CDR0000062897__AboutThis_11">Some of the reference citations in this summary are accompanied by a level-of-evidence designation. These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Adult Treatment Editorial Board uses a <a href="/books/n/pdqcis/CDR0000062796/">formal evidence ranking system</a> in developing its level-of-evidence designations.</p></div><div id="CDR0000062897__AboutThis_12"><h3>Permission to Use This Summary</h3><p id="CDR0000062897__AboutThis_13">PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks succinctly: [include excerpt from the summary].”</p><p id="CDR0000062897__AboutThis_14">The preferred citation for this PDQ summary is:</p><p id="CDR0000062897__AboutThis_15">PDQ® Adult Treatment Editorial Board. PDQ Penile Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/penile/hp/penile-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/penile/hp/penile-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389381]</p><p id="CDR0000062897__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>, a collection of over 2,000 scientific images.
|
|
</p></div><div id="CDR0000062897__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062897__AboutThis_18">Based on the strength of the available evidence, treatment options may be described as either “standard” or “under clinical evaluation.” These classifications should not be used as a basis for insurance reimbursement determinations. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062897__AboutThis_20"><h3>Contact Us</h3><p id="CDR0000062897__AboutThis_21">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Email Us</a>.</p></div></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65943</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389381" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389381</a></span></div></div></div>
|
|
|
|
</div>
|
|
|
|
<!-- Custom content below content -->
|
|
<div class="col4">
|
|
|
|
</div>
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<!-- Custom contetnt below bottom nav -->
|
|
<div class="col5">
|
|
|
|
</div>
|
|
</div>
|
|
|
|
<div id="rightcolumn" class="four_col col last">
|
|
<!-- Custom content above discovery portlets -->
|
|
<div class="col6">
|
|
<div id="ncbi_share_book"><a href="#" class="ncbi_share" data-ncbi_share_config="popup:false,shorten:true" ref="id=NBK65943&db=books">Share</a></div>
|
|
|
|
</div>
|
|
<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65943.5/?report=reader">PubReader</a></li><li><a href="/books/NBK65943.5/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK65943" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK65943" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Penile Cancer Treatment (PDQ®): Health Professional Version. 2018 Jan 30. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK65943.16/">NBK65943.16</a></span> February 2, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK65943.15/">NBK65943.15</a></span> June 2, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65943.14/">NBK65943.14</a></span> February 10, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK65943.13/">NBK65943.13</a></span> February 2, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK65943.12/">NBK65943.12</a></span> July 22, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65943.11/">NBK65943.11</a></span> February 11, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK65943.10/">NBK65943.10</a></span> August 3, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK65943.9/">NBK65943.9</a></span> March 24, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65943.8/">NBK65943.8</a></span> February 6, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK65943.7/">NBK65943.7</a></span> October 17, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK65943.6/">NBK65943.6</a></span> August 9, 2018</li><li><span class="bk_col_itm">NBK65943.5</span> January 30, 2018 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK65943.4/">NBK65943.4</a></span> February 3, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK65943.3/">NBK65943.3</a></span> February 18, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65943.2/">NBK65943.2</a></span> February 10, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK65943.1/">NBK65943.1</a></span> February 5, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062897__1" ref="log$=inpage&link_id=inpage">General Information About Penile Cancer</a></li><li><a href="#CDR0000062897__4" ref="log$=inpage&link_id=inpage">Cellular Classification of Penile Cancer</a></li><li><a href="#CDR0000062897__6" ref="log$=inpage&link_id=inpage">Stage Information for Penile Cancer</a></li><li><a href="#CDR0000062897__122" ref="log$=inpage&link_id=inpage">Stage 0 Penile Cancer</a></li><li><a href="#CDR0000062897__39" ref="log$=inpage&link_id=inpage">Stage I Penile Cancer</a></li><li><a href="#CDR0000062897__51" ref="log$=inpage&link_id=inpage">Stage II Penile Cancer</a></li><li><a href="#CDR0000062897__58" ref="log$=inpage&link_id=inpage">Stage III Penile Cancer</a></li><li><a href="#CDR0000062897__69" ref="log$=inpage&link_id=inpage">Stage IV Penile Cancer</a></li><li><a href="#CDR0000062897__77" ref="log$=inpage&link_id=inpage">Recurrent Penile Cancer</a></li><li><a href="#CDR0000062897__97" ref="log$=inpage&link_id=inpage">Changes to This Summary (01/30/2018)</a></li><li><a href="#CDR0000062897__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65814/">Patient Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pmc&DbFrom=books&Cmd=Link&LinkName=books_pmc_refs&IdsFromResult=2822564" ref="log$=recordlinks">PMC</a><div class="brieflinkpop offscreen_noflow">PubMed Central citations</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=2822564" ref="log$=recordlinks">PubMed</a><div class="brieflinkpop offscreen_noflow">Links to PubMed</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389244" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Lymphedema (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Lymphedema (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Supportive and Palliative Care Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389442" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389190" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389493" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cervical Cancer Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cervical Cancer Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389471" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Treatment (PDQ®): Health Professional Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Prostate Cancer Treatment (PDQ®): Health Professional Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=26389381" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=26389381" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c93c00b15b832ebc4a987f">Penile Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries</a><div class="ralinkpop offscreen_noflow">Penile Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_qry two_line"><a class="htb" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c93bf0f4a390645e72cffe">PMC Links for Books (Select 2829122) <span class="number">(8)</span></a><div class="tertiary">PMC</div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c93beff4a390645e72c73b">Gallbladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries</a><div class="ralinkpop offscreen_noflow">Gallbladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
|
|
|
|
<!-- Custom content below discovery portlets -->
|
|
<div class="col7">
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom content after all -->
|
|
<div class="col8">
|
|
|
|
</div>
|
|
<div class="col9">
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/corehtml/pmc/js/jquery.scrollTo-1.4.2.js"></script>
|
|
<script type="text/javascript">
|
|
(function($){
|
|
$('.skiplink').each(function(i, item){
|
|
var href = $($(item).attr('href'));
|
|
href.attr('tabindex', '-1').addClass('skiptarget'); // ensure the target can receive focus
|
|
$(item).on('click', function(event){
|
|
event.preventDefault();
|
|
$.scrollTo(href, 0, {
|
|
onAfter: function(){
|
|
href.focus();
|
|
}
|
|
});
|
|
});
|
|
});
|
|
})(jQuery);
|
|
</script>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<div class="footer" id="footer">
|
|
<section class="icon-section">
|
|
<div id="icon-section-header" class="icon-section_header">Follow NCBI</div>
|
|
<div class="grid-container container">
|
|
<div class="icon-section_container">
|
|
<a class="footer-icon" id="footer_twitter" href="https://twitter.com/ncbi" aria-label="Twitter"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11 {
|
|
fill: #737373;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>Twitter</title>
|
|
<path class="cls-11" d="M250.11,105.48c-7,3.14-13,3.25-19.27.14,8.12-4.86,8.49-8.27,11.43-17.46a78.8,78.8,0,0,1-25,9.55,39.35,39.35,0,0,0-67,35.85,111.6,111.6,0,0,1-81-41.08A39.37,39.37,0,0,0,81.47,145a39.08,39.08,0,0,1-17.8-4.92c0,.17,0,.33,0,.5a39.32,39.32,0,0,0,31.53,38.54,39.26,39.26,0,0,1-17.75.68,39.37,39.37,0,0,0,36.72,27.3A79.07,79.07,0,0,1,56,223.34,111.31,111.31,0,0,0,116.22,241c72.3,0,111.83-59.9,111.83-111.84,0-1.71,0-3.4-.1-5.09C235.62,118.54,244.84,113.37,250.11,105.48Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_facebook" href="https://www.facebook.com/ncbi.nlm" aria-label="Facebook"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>Facebook</title>
|
|
<path class="cls-11" d="M210.5,115.12H171.74V97.82c0-8.14,5.39-10,9.19-10h27.14V52l-39.32-.12c-35.66,0-42.42,26.68-42.42,43.77v19.48H99.09v36.32h27.24v109h45.41v-109h35Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_linkedin" href="https://www.linkedin.com/company/ncbinlm" aria-label="LinkedIn"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>LinkedIn</title>
|
|
<path class="cls-11" d="M101.64,243.37H57.79v-114h43.85Zm-22-131.54h-.26c-13.25,0-21.82-10.36-21.82-21.76,0-11.65,8.84-21.15,22.33-21.15S101.7,78.72,102,90.38C102,101.77,93.4,111.83,79.63,111.83Zm100.93,52.61A17.54,17.54,0,0,0,163,182v61.39H119.18s.51-105.23,0-114H163v13a54.33,54.33,0,0,1,34.54-12.66c26,0,44.39,18.8,44.39,55.29v58.35H198.1V182A17.54,17.54,0,0,0,180.56,164.44Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_github" href="https://github.com/ncbi" aria-label="GitHub"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11,
|
|
.cls-12 {
|
|
fill: #737373;
|
|
}
|
|
|
|
.cls-11 {
|
|
fill-rule: evenodd;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>GitHub</title>
|
|
<path class="cls-11" d="M151.36,47.28a105.76,105.76,0,0,0-33.43,206.1c5.28,1,7.22-2.3,7.22-5.09,0-2.52-.09-10.85-.14-19.69-29.42,6.4-35.63-12.48-35.63-12.48-4.81-12.22-11.74-15.47-11.74-15.47-9.59-6.56.73-6.43.73-6.43,10.61.75,16.21,10.9,16.21,10.9,9.43,16.17,24.73,11.49,30.77,8.79,1-6.83,3.69-11.5,6.71-14.14C108.57,197.1,83.88,188,83.88,147.51a40.92,40.92,0,0,1,10.9-28.39c-1.1-2.66-4.72-13.42,1-28,0,0,8.88-2.84,29.09,10.84a100.26,100.26,0,0,1,53,0C198,88.3,206.9,91.14,206.9,91.14c5.76,14.56,2.14,25.32,1,28a40.87,40.87,0,0,1,10.89,28.39c0,40.62-24.74,49.56-48.29,52.18,3.79,3.28,7.17,9.71,7.17,19.58,0,14.15-.12,25.54-.12,29,0,2.82,1.9,6.11,7.26,5.07A105.76,105.76,0,0,0,151.36,47.28Z">
|
|
</path>
|
|
<path class="cls-12" d="M85.66,199.12c-.23.52-1.06.68-1.81.32s-1.2-1.06-.95-1.59,1.06-.69,1.82-.33,1.21,1.07.94,1.6Zm-1.3-1">
|
|
</path>
|
|
<path class="cls-12" d="M90,203.89c-.51.47-1.49.25-2.16-.49a1.61,1.61,0,0,1-.31-2.19c.52-.47,1.47-.25,2.17.49s.82,1.72.3,2.19Zm-1-1.08">
|
|
</path>
|
|
<path class="cls-12" d="M94.12,210c-.65.46-1.71,0-2.37-.91s-.64-2.07,0-2.52,1.7,0,2.36.89.65,2.08,0,2.54Zm0,0"></path>
|
|
<path class="cls-12" d="M99.83,215.87c-.58.64-1.82.47-2.72-.41s-1.18-2.06-.6-2.7,1.83-.46,2.74.41,1.2,2.07.58,2.7Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M107.71,219.29c-.26.82-1.45,1.2-2.64.85s-2-1.34-1.74-2.17,1.44-1.23,2.65-.85,2,1.32,1.73,2.17Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M116.36,219.92c0,.87-1,1.59-2.24,1.61s-2.29-.68-2.3-1.54,1-1.59,2.26-1.61,2.28.67,2.28,1.54Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M124.42,218.55c.15.85-.73,1.72-2,1.95s-2.37-.3-2.52-1.14.73-1.75,2-2,2.37.29,2.53,1.16Zm0,0"></path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_blog" href="https://ncbiinsights.ncbi.nlm.nih.gov/" aria-label="Blog">
|
|
<svg xmlns="http://www.w3.org/2000/svg" id="Layer_1" data-name="Layer 1" viewBox="0 0 40 40">
|
|
<defs><style>.cls-1{fill:#737373;}</style></defs>
|
|
<title>NCBI Insights Blog</title>
|
|
<path class="cls-1" d="M14,30a4,4,0,1,1-4-4,4,4,0,0,1,4,4Zm11,3A19,19,0,0,0,7.05,15a1,1,0,0,0-1,1v3a1,1,0,0,0,.93,1A14,14,0,0,1,20,33.07,1,1,0,0,0,21,34h3a1,1,0,0,0,1-1Zm9,0A28,28,0,0,0,7,6,1,1,0,0,0,6,7v3a1,1,0,0,0,1,1A23,23,0,0,1,29,33a1,1,0,0,0,1,1h3A1,1,0,0,0,34,33Z"></path>
|
|
</svg>
|
|
</a>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
|
|
<section class="container-fluid bg-primary">
|
|
<div class="container pt-5">
|
|
<div class="row mt-3">
|
|
<div class="col-lg-3 col-12">
|
|
<p><a class="text-white" href="https://www.nlm.nih.gov/socialmedia/index.html">Connect with NLM</a></p>
|
|
<ul class="list-inline social_media">
|
|
<li class="list-inline-item"><a href="https://twitter.com/NLM_NIH" aria-label="Twitter" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st20 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st30 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Twitter</title>
|
|
<g>
|
|
<g>
|
|
<g>
|
|
<path class="st20" d="M192.9,88.1c-5,2.2-9.2,2.3-13.6,0.1c5.7-3.4,6-5.8,8.1-12.3c-5.4,3.2-11.4,5.5-17.6,6.7 c-10.5-11.2-28.1-11.7-39.2-1.2c-7.2,6.8-10.2,16.9-8,26.5c-22.3-1.1-43.1-11.7-57.2-29C58,91.6,61.8,107.9,74,116 c-4.4-0.1-8.7-1.3-12.6-3.4c0,0.1,0,0.2,0,0.4c0,13.2,9.3,24.6,22.3,27.2c-4.1,1.1-8.4,1.3-12.5,0.5c3.6,11.3,14,19,25.9,19.3 c-11.6,9.1-26.4,13.2-41.1,11.5c12.7,8.1,27.4,12.5,42.5,12.5c51,0,78.9-42.2,78.9-78.9c0-1.2,0-2.4-0.1-3.6 C182.7,97.4,189.2,93.7,192.9,88.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st30" cx="124.4" cy="128.8" r="108.2"></circle>
|
|
</g>
|
|
</svg></a></li>
|
|
<li class="list-inline-item"><a href="https://www.facebook.com/nationallibraryofmedicine" aria-label="Facebook" rel="noopener noreferrer" target="_blank">
|
|
<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st10 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st110 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Facebook</title>
|
|
<g>
|
|
<g>
|
|
<path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st110" cx="123.6" cy="123.2" r="108.2"></circle>
|
|
</svg>
|
|
</a></li>
|
|
<li class="list-inline-item"><a href="https://www.youtube.com/user/NLMNIH" aria-label="Youtube" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<title>Youtube</title>
|
|
<style type="text/css">
|
|
.st4 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
|
|
.st5 {
|
|
fill: #FFFFFF;
|
|
}
|
|
</style>
|
|
<circle class="st4" cx="124.2" cy="123.4" r="108.2"></circle>
|
|
<g transform="translate(0,-952.36218)">
|
|
<path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path>
|
|
</g>
|
|
</svg></a></li>
|
|
</ul>
|
|
</div>
|
|
<div class="col-lg-3 col-12">
|
|
<p class="address_footer text-white">National Library of Medicine<br />
|
|
<a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white" target="_blank" rel="noopener noreferrer">8600 Rockville Pike<br />
|
|
Bethesda, MD 20894</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
|
|
<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
|
|
<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
|
|
<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
|
|
<a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p>
|
|
</div>
|
|
</div>
|
|
<div class="row">
|
|
<div class="col-lg-12 centered-lg">
|
|
<nav class="bottom-links">
|
|
<ul class="mt-3">
|
|
<li>
|
|
<a class="text-white" href="//www.nlm.nih.gov/">NLM</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.nih.gov/">NIH</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.hhs.gov/">HHS</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.usa.gov/">USA.gov</a>
|
|
</li>
|
|
</ul>
|
|
</nav>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIConfigJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js?v=1"> </script>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/static/js/hfjs2.js"> </script>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK65943&ncbi_domain=pdqcis&ncbi_report=record&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK65943.5/&ncbi_pagename=Penile Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf&ncbi_bookparttype=chapter&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal106 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/4062932/4209313/4212053/4076480/3921943/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |