EAU & ASCO: Penile Cancer 2023: Difference between revisions

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* '''Pre-operative MRI or US can assist in surgical planning'''

* '''cT2 (corpus spongiosum)'''

* '''cT2 (corpus spongiosum): gGlansectomy (partial or total), with or without reconstruction'''

** '''~~Option~~ (1)~~'''~~

** If doubt of corporeal or tunica albuginea invasion, rather than continuing the dissection over Buck’s fascia to perform glansectomy combined with distal corporectomy, dissection superficial to the tunica albuginea can be adopted after dividing the neurovascular bundle.

**# '''Glansectomy (partial or total), with or without reconstruction'''

*** Frozen sections of the corporeal tips and urethra may be helpful in assessing the radicality of the procedure peri-operatively.

**#* If doubt of corporeal or tunica albuginea invasion, rather than continuing the dissection over Buck’s fascia to perform glansectomy combined with distal corporectomy, dissection superficial to the tunica albuginea can be adopted after dividing the neurovascular bundle.

**#** Frozen sections of the corporeal tips and urethra may be helpful in assessing the radicality of the procedure peri-operatively.

* '''cT3 (corpus cavernosum): partial amputation'''

* '''cT3 (corpus cavernosum)'''

** '''~~Option~~ (1)~~'''~~

**# '''Partial amputation'''

** Reconstructive options can be offered, such as (2)

**# Urethral centralisation and/or

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** '''Radical amputation and diversion of urination with a perineal urethrostomy is reserved for those patients in whom a resection with a safe margin would result in the inability to void standing upright or without wetting the scrotum.'''

** In case of locally-advanced and ulcerated cases which are resectable, composite myocutaneous flaps or advancement flaps may be needed to cover the surgical defect

* Radiotherapy for locally-advanced penile lesions should be undertaken with concurrent chemotherapy.

@@ Line 400: / Line 400: @@
 * '''Pre-operative MRI or US can assist in surgical planning'''
-* '''cT2 (corpus spongiosum)'''
+* '''<span style="color:#ff0000">cT2 (corpus spongiosum): g<span style="color:#ff0000">Glansectomy (partial or total), with or without reconstruction'''
-** '''<span style="color:#ff0000">Option (1)'''
+** If doubt of corporeal or tunica albuginea invasion, rather than continuing the dissection over Buck’s fascia to perform glansectomy combined with distal corporectomy, dissection superficial to the tunica albuginea can be adopted after dividing the neurovascular bundle.
-**# '''<span style="color:#ff0000">Glansectomy (partial or total), with or without reconstruction'''
+*** Frozen sections of the corporeal tips and urethra may be helpful in assessing the radicality of the procedure peri-operatively.
-**#* If doubt of corporeal or tunica albuginea invasion, rather than continuing the dissection over Buck’s fascia to perform glansectomy combined with distal corporectomy, dissection superficial to the tunica albuginea can be adopted after dividing the neurovascular bundle.
-**#** Frozen sections of the corporeal tips and urethra may be helpful in assessing the radicality of the procedure peri-operatively.
+* <span style="color:#ff0000">'''cT3 (corpus cavernosum): partial amputation'''
-* '''cT3 (corpus cavernosum)'''
-** <span style="color:#ff0000">'''Option (1)'''
-**# '''Partial amputation'''
 ** Reconstructive options can be offered, such as (2)
 **# Urethral centralisation and/or
@@ Line 416: / Line 413: @@
 ** '''Radical amputation and diversion of urination with a perineal urethrostomy is reserved for those patients in whom a resection with a safe margin would result in the inability to void standing upright or without wetting the scrotum.'''
 ** In case of locally-advanced and ulcerated cases which are resectable, composite myocutaneous flaps or advancement flaps may be needed to cover the surgical defect
 * Radiotherapy for locally-advanced penile lesions should be undertaken with concurrent chemotherapy.