Editing EAU & ASCO: Penile Cancer 2023 (section)

===== Non-surgical =====

====== Topical ======
* '''<span style="color:#ff0000">Indications'''
**'''<span style="color:#ff0000">Biopsy-confirmed PeIN'''
*'''Options'''
*#'''Imiquimod'''
*#'''5-fluorouracil'''
*Dosing
** Imiquimod
*** Commonly used 3 times per week for 12 weeks
** 5-fluorouracil
*** No standard protocol exists
*** 5-FU ointment on for 12 hours every 48 hours during a 4 to 6-week treatment course is often recommended
*Adverse events
**Discontinuation of topical agents due to side effects observed in 12% of cases

====== Laser ======
*'''Options'''
** '''Neodymium:Yttrium-Aluminium-Garnet (Nd:YAG''', penetration 4–6 mm, wavelength 1064 nm)
** '''Carbon dioxide (CO2''', penetration < 1 mm, wavelength 10600 nm)
* '''<span style="color:#ff0000"> Indications
** '''<span style="color:#ff0000"> Biopsy-confirmed PeIN, Ta, or T1 lesions

====== Radiation ======
*Efficacy
**5-year recurrence-free survival improved with brachytherapy compared to EBRT (≈80% vs. ≈55%)
*'''<span style="color:#ff0000">Indications
**'''<span style="color:#ff0000">Biopsy-confirmed T1 or T2 lesions

====== Moh’s micrographic surgery ======
*A surgical technique by which tissue is excised and processed with en face histological margins in real time to give a complete circumferential and deep margin
**Aims at maximal organ-preservation by adopting margin-guided excision
*'''Not routinely recommended as data are very limited'''