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21 Penis Cancer

Source: www.estroweb.org
Topic: Penis
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Sort Desciption: Penile carcinoma is relatively uncommon in Western Countries, representing approximately 1% of male cancers. (10) Carcinoma of the penis is virtually unknown in Jews, ...

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Penile carcinoma is relatively uncommon in Western Countries, representing approximately 1% of male cancers. (10) Carcinoma of the penis is virtually unknown in Jews, who practice infant circumcision, and it is seen only occasionally in Moslems, who delay circumcision until the ages of 313. These tumours occur almost exclusively in uncircumcised men, usually after the age of 50, and are often associated with phimosis (Fig 21.1) and subsequent poor hygiene. (10) The main aetiological factor is chronic irritation due to smegma and secretion associated with HPV, (29,15) and this is exacerbated by phimosis, which is present in 20 30% of the population with penile cancer. (1,4) Fig 21.1: Partial phimosis with a tumour of the glans. Symptoms are in decreasing order: mass lesions, pain, itching, bleeding, groin nodes, urinary symptoms. Secondary infections are very common. (10,11) Inguinal lymph node status is the most important prognostic factor, as demonstrated in a large multicentric retrospective study (35): with negative nodes the 5 year survival was 66%; with positive nodes it was only 27% (35). In a univariate analysis performed at the IGR of 102 patients treated with brachytherapy (33), the following prognostic factors were found, given in decreasing order of importance: nodal status, tumour size, corpus involvement, age, verrucous histologic type. Surgical management is effective in treating penile cancer, ...

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