Mohs Micrographic Surgery For Penile Cancer: Management And Long-Term Follow Up - Beyond The Abstract

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 22 Oct 2007 - 0:00 PDT

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UroToday.com - Although rare in the United States, penile cancer is a potentially lethal and psychologically devastating malignancy. Conventional treatment with partial or total penectomy is rejected by many patients leading to needless morbidity and mortality.

Tissue sparing approaches have been developed to preserve as much functional penile tissue as possible while completely eradicating malignancy. For select patients with low grade disease, local therapies such as radiation, laser vaporization, or excision with a narrow margin produce good results.

Moh's micrographic surgery (MMS) is time intensive and requires the services of a specially trained dermatologic surgeon. However, MMS permits excision of malignant tissues with an ultra-fine margin as determined by intra-operative microscopic examination of sectioned tissue. This process maximizes the amount of normal tissue preserved while completely eradicating tumor. It is important to keep in mind that the urologist must remain closely involved in the management of penile CA patients after MMS as urologic complications such as meatal stenosis can arise.

Unfortunately, permission was not granted by our IRB to contact patient in our series to assess their post-operative functional status. Office chart review suggested that most patients were generally satisfied with the procedure but definitive statements on patient satisfaction cannot be made based on our available data. It must also be conceded that our recurrence rate was relatively high. Nevertheless, the long term progression and survival rates were similar to that found in patients treated with more aggressive surgical interventions. For patients with low grade disease, MMS is an attractive tissue-preserving option in the management of penile cancer.

Written by
Alan Shindel MD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

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