Penile carcinoma: A single institution experience

Introduction. Penile cancer is known to be a rare entity in developed countries with an incidence established to be less than 0.6%. The aim of this study is to describe our experience with penile cancer regarding demographics, clinical data, risk factors and, recurrence. Methods. We retrospectively evaluated our experience in treating penile cancer between 1996 and 2008. Demographic data, associated risks factors, history of circumcision, presence of HPV, and HIV status were documented. Clinical stage at presentation was recorded. Follow-up consisted of clinical and/or radiographic evidence of recurrence. Results. We identified 34 patients who were treated for carcinoma of the penis. Mean patient age was 57 years (32-84). Of the 34 patients, 19 (56%) were Hispanic, 21 (62%) were uncircumcised, 8 (24%) had pathologic evidence of HPV, and 6 (18%) were HIV-positive. A total of 28 patients (82%) were available for follow-up. The majority of the lesions were low-grade (Tis, T1). The treatment goal for low-stage, low-grade tumors was organ preservation. Eight lymphadenectomies were performed. Three patients presented with positive lymphadenopathy. Nine patients (26%) developed a post-operative complication. At a mean of 47 months follow-up, 7 of 28 patients (21%) had clinical and/or radiologic evidence of recurrence. Four of these patients had T1 disease at diagnosis. Conclusion. In our experience, a significant number of patients were found to be HIV-positive as well as having other known risks factors of penile cancer, including evidence of HPV and history of circumcision. The recurrence for T1 disease was high, particularly for patients treated with organ sparing techniques, and several patients were lost to follow-up. Overall, our experience highlights many of the unique characteristics involved in the management of penile cancer.