Penile-preserving surgery in penile carcinoma

Penile cancer is an uncommon cancer involving the glans, prepuce or both in over 75% cases. Historically, the standard treatment of the primary tumor has been a partial or total penectomy. Although these are still widely practiced procedures for control of the disease, as our understanding of the natural history of the disease has evolved, the treatment options have broadened, focusing more and more on penile-preserving techniques such as Mohs′s micrographic surgery, wide local excision, subtotal and total glansectomy, laser, brachytherapy, external beam radiotherapy and topical application of chemotherapeutic agents such as 5-Fluorouracil. Penile-preserving options are increasingly being used as a first-line treatment, not restricted to Tis/Ta tumors, but for T1, T2 and even T3 tumors in selected cases. The metastatic stage of the tumor does not influence the treatment of the primary lesion. In this review, we discuss the various penile-preserving options currently available and their role in the management of penile carcinoma of various stages