PubMed1975
From the study of this series of 50 patients suffering from cancer of the penis, and in particular from the comparison of two successive groups, several facts stand out which determine our present attitude: -subjects suffering from cancer of the penis, at least in our area, are aged, fragile people, whose cause of death, in more than half of the cases, was not the penile cancer. Proposable therapeutic methods must take this specific background into account; -tumoral and glandular indications must be looked at separately, as there does not seem to be any strict correlation between the size of the tumor and glandular invasion; -inguinal glandular invasion must as far as possible, be proved histologically, whatever the appearance of adenopathy on palpation; -No and N-patients should not be treated in the inguinal folds, but carefully followed-up; in this connection, very strict follow-up, at least for the first three years, seems to be indispensable; -N+ patients must evidently undergo bilateral removal and subsequent irradiation. This therapeutic attitude, leads to bilateral edema of the lower limbs in a high percentage of cases, against which no therapy is at present active; -tumors of the penis, classified T1, T2, or T3 are best benefitted by the technique of interstitial curietherapy using irridium 192, the only conservative technique offering a high level of local sterilization, without major after-effects; it permits possible reparatory surgery; -on the other hand, T4 tumors cannot be marked, the target-volume being too large, and they justify radical surgery.