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17th European Urology Residents Education Programme > Penile cancer > Flashcards

Penile cancer Flashcards

1
Q

What is the incidence of penile cancer in Europe and USA?

A

<1.0/100,000

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2
Q

In what country is penile cancer the most common male malignancy?

A

Uganda

it is also more common in India and Brazil 8.3/100,000

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3
Q

What are the risk factors for penile cancer?

A

Phimosis
HPV
Smoking

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4
Q

Penile cancer are caused by HPV in what % of cases?

A

45%

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5
Q

Penile cancer T1?

A

Tumour invades subepithelial connective tissue

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6
Q

Penile cancer T1a?

A

Tumour invades subepithelial connective tissue without lymphovascular invasion and is not poorly differentiated

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7
Q

Penile cancer T1b?

A

Tumour invades subepithelial connective tissue with lymphovascular invasion or is poorly differentiated

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8
Q

Penile cancer T2?

A

Tumour invades corpus spongiosum with or without invasion of the urethra

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9
Q

Penile cancer T3?

A

Tumour invades corpus scavernosum with or without invasion of the urethra

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10
Q

Penile cancer N1?

p?

A

Palpable mobile unilateral inguinal lymph node

Metastasis in one or two inguinal lymph nodes

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11
Q

Penile cancer N2?

p?

A

Palpable mobile multiple or bilateral inguinal lymph nodes

Metatstasis in more than two unilataeral inguinal nodes or bilateral inguinal lymph nodes

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12
Q

Penile cancer N3?

p?

A

Fixed inguinal nodal mass or pelvic lymphadenopathy, unilateral or bilateral
(Metastasis in pelvic lymph node(s), unilatera or bilateral extranodal or extension of regional lymph node metastasis)

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13
Q

How should you treat penile cancer PeIN(CIS),Ta and T1a (G1-2)?

A

Localised lesion:
Excision/circumcision

Flat lesions: 
Local destruction  (ex YAG or CO2, laser, cryo)
Topical therapy (5-FU, imiquimod, fotodynamic therapy)

alternative: resurfacing (with skin graft)

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14
Q

Mentions two methods of topical therapy you can use for superficial penile cancer?

A

5-FU

imiquimod

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15
Q

How should you treat penile cancer T1aG3, T1b, T2?

A

Glansectomy

alternative: Brachyradiotherapy (in lesions <4 cm)

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16
Q

How should you treat penile cancer T3?

A

Partial/total penectomy

17
Q

How should you treat penile cancer T4

A

Emasculation

18
Q

What treatments for superficial penile cancer have the highest local recurrence?

A

lasers and brachytherapy

19
Q

What are the chances of sufficient erection after glansectomy or partial amputation?

A

66,7%

20
Q

What are the chances of orgasms after glansectomy or partial amputation?

A

72,2%

21
Q

What are the chances of restoration of regular sexual intercourse after glansectomy or partial amputation?

A

55,6%

22
Q

What are the complications of Radiotherapy for penile cancer?

A

Stricture of urethra 20-35%
Necrosis of glans 10-20%
Late fibrosis of corpora cavernosa

23
Q

What is the success rate for radiotherapy of T1aG3, T1b, T2 penile cancer?

A

70-90%

24
Q

What professions should be part of at multidisciplinary team treating penile cancer?

A 
Dermatovenerologist
Urologist
Pathologist
Radiologist
Medical oncologist
Radiotherapeutist
25
Q

When should you perform sentinel node in penile cancer?

A

≥ T1G2

26
Q

What is an alternative to sentinel node in ≥ T1G2 penile cancer?

A

bilateral modified inguinal lymphadenectomy (mILND)

27
Q

What is the advantage of sentinel node over bilateral modified inguinal lymphadenectomy (mILND) in ≥ T1G2 penile cancer?

A

decreased morbidity

28
Q

How should your treat penile cancer cN1/N2?

A

radical inguinal lymphadenectomy (rILND)

29
Q

How should your treat penile cancer cN3?

A

chemotherapy followed by radical inguinal lymphadenectomy (rILND)

30
Q

What measures should be taken to decrease morbidity after inguinal lymphadenectomy (ILND)?

A

Ligation/clips on lymph vessels instead of diathermia
Saphenous vein preservation
Compression stockings
Prophylactic antibiotics until drains are removed
Vacuum dressings

31
Q

When is chemotherapy given in penile cancer?

A

Adjuvant p N2-3
Neoadjuvant T4
Palliative

17th European Urology Residents Education Programme (17 decks)

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