Ca Penis Flashcards
Risk factors
Smoking
Uv
Hpv
Balanitis
Mc site
Glns> prepuce
Premalingan lesions
Cutaneous horn
Pkmb
Male lichen sclerosus
Condyloma acuminatum
T stage
1a- no lvi or pni not high grade
b- +
1- glans foreskin shaft
2-corpus spongiosim with or witjout urethral inv
3- corpora cavernosum+/- urethr
4- adjacent structures scrotum prostate pubic bone
N stage
1- mobile ul ing node
2- mobile more than or equal 2 ul or bl
3- fixed ing nodal mas pelvic lne ul or bl
Margin for penile ca
Gr 1 and 2- 5 mm
3- 10 mm
Max depth of penetration laser
Nd yag 6 mm
Inguinal node dissection when
T1b or higher
As thers 50% chance of ln mets
Modified Ln dissection limits
Inguinl ligament
Sartorius and adductor longus
Medial to fa and fv
Low grade 1,2 how many
80%
Molecular analysis
Hpv 16 33 in 12%
Egfr overexp all
P16 28%
M1 at presentation
2%
Mc site fir mets in penis
Lung bone liver
Molecular markers in penile ca
Hpv
P53
Sccag
Ki67
N2 5 yr survival
30%
N3-0
N0- 93
N1-84
Verrucus ca intra arotic infusion
Methotrexate
Parallel opposed field RT
T2 t3
Brachytherapy in penile ca
T1 and 2
Which form useless in bulky tr
Obese short penis
Deep infiltration
Interstitial brachytherapy
Ul lnd is enough in
Metachronous ul lne
Ln managemnet
T1a no - surveillnce
T1b and above lndissection
N+- ul less than 4 cm mobile positive do ilnd nac fb nd
More than or equ 4 cm Cisplatin based nact then ilnd or plnd
Fixed node or bl pne
Nact
When to do plnd
Ipsi if more than 2 inguinal node positive same side
Bilateral plnd
When more than 4
Nact
TIP
Egfr inhib
Dacomitinib
Recent drugs
Cetuxi
Pembroli
