Penile Flashcards
What is the difference between T1a and T1b penile cancer?
T1a: not HG (grade 3), no LVI and no perineural (PNI) invasion
T1b: HG, presence of LVI or PNI
What is Tis penile cancer?
Penile intraepithelial neoplasia
What is Bowens Disease?
Penile lesion on the shaft
What is erythoplasia of Queryat?
Penile lesion on the glans
What is T1 disease in the:
- glans
- foreskin
- shaft?
glans: invades LP
foreskin: invades dermis, LP or dartos fascia
shaft: invades connective tissue between epidermis and corpora regardless of location
What is the difference between T2 and T3 disease in penile cancer?
T2 invades corpus spongeiosum with or without urethral invasion
T3 invades corpora cavernosa (including tunica albuginea) with or without urethral invasion
What are predictors of metastasis for SCC of penis?
grade, stage, PNI or LVI
How does 5FU work?
blocks DNA synthesis - inhibits thymidylate synthetase actiity
What are the boarders of an inguinal node dissection?
superior - Inguinal ligament
lateral - sartorious
medial - adductor longus
When do you do pelvic LNs if nodes are nonbulky and mobile?
If >3 + inguinal nodes
What do you do for fixed inguinal nodes?
Chemotherapy then PLND and bilateral inguinal LN dissection
When do you FNA pelvic lymph nodes?
If marginal size, ~1-2cm
What is the chemo regimen for penile cancer?
TIP - paclitaxel, ifosfamide, cisplatin
or
5FU + Cisplatin
When would you do unilateral inguinal node dissection?
If unilateral palpable recurrence after extended period of surveillance (>6-9mos)
What is Bushke lowenstein
Verrucous Carcinoma
No LND required