Contemporary experience in management of squamous cell carcinoma of the penis in Hong Kong: lessons learned over 20 years

Abstract

Introduction: Squamous cell carcinoma of the penis (SCCp) is rare. Optimal management of SCCp remains challenging. This study aims to provide a contemporary perspective to current management of SCCp at two institutions in Hong Kong. Methods: A retrospective analysis was conducted. Patients with SCCp between1997 and July 2017 at two institutions were identified using an institutional database. Patients who received treatment for histologically proven SCCp were eligible for the study. Patient demographics, clinical features, pathological staging, treatment approach and clinical outcomes were recorded. Results: Sixty-nine patients were eligible, with median age of 65 (range 34-90). Mean time from development of symptoms to presentation was 10 months. Of the 56 patients who had surgical treatment for primary tumour, 52(93%) had partial or radical penectomy. Only 3 patients had positive surgical margins. 43(77%) of patients had T2 on final pathology, potentially eligible for organ-preserving surgery. Despite poor sensitivity, CT was the most common imaging modality used for nodal staging. 19(28%) patients pN+ disease following inguinal lymphadenectomy. With a median follow-up of 115 months, 25(36%) of the patients died of SCCp. Conclusion: SCCp patients in Hong Kong often present late, and is associated with high mortality rate. Penectomy was the commonest surgical treatment used, although many appeared eligible for organ-preserving surgery. Many patients underwent inguinal lymphadenectomy unnecessarily, and a development of a dynamic sentinel lymph node service is needed.