A prospective study of total glans resurfacing in localised penile cancer to maximise oncological and functional outcomes within a tertiary referral network

Penile cancer is a rare malignancy worldwide, representing only 1% of all cancers affecting men. There is little data outlining the comparative effectiveness of penile preservation techniques, and no guidelines regarding their use currently exist. Outcomes data reporting is non-standardised, and follow-up not measured consistently. The aim of this study was to outcomes of total glans resurfacing (TGR) in oncological control, form and function in localized penile cancer MATERIALS AND METHODS: Between 2013-2015, 19 prospectively-enrolled patients underwent total glans resurfacing. Demographics, cosmesis, patient satisfaction, and disease recurrence were assessed at follow-up to quantify the oncologic and functional outcomes. At 3 months of follow-up patients completed questionnaires detailing erectile and sexual function (International Index of Erectile Function, IIEF) and general satisfaction with the visual analogue scale (VAS). All statistical analysis was performed using Prism 6 software (Prism 6, GraphPad Softward, California, USA) RESULTS: No perioperative complications were experienced, and 94.7% had a complete graft take with a with a median cosmesis score of 5/5 on visual analogue scale. There was one local, and no regional nodal recurrences after a mean follow-up of 23 months. 1-yr progression-free survival (PFS) and overall survival (OS) rates were 100%. The 1-yr recurrence-free survival rate was 95%. 81% patients reported an improved sex-life postoperatively CONCLUSIONS: Total glans resurfacing is a viable and acceptable option for glans preservation in those patients with localized penile cancer, and demonstrates acceptable functional and oncological outcomes. We believe that TGR should be considered in all cases of localized penile cancer.

The Journal of urology. 2016 Dec 24 [Epub ahead of print]

F O'Kelly, P Lonergan, D Lundon, G Nason, P Sweeney, I Cullen, P Hegarty

Dept. of Urological Surgery, Mater Misericordiae University Hospital, Dublin 8., Dept. of UroOncology, Mercy University Hospital, Cork., Dept. of Urology and Andrology, University Hospital, Waterford.

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