Baumgarten A, et al. - This paper entailed the investigation of the recurrence outcomes of penile sparing surgery (PSS) in the largest multicenter cohort of patients to date. Excellent local control could be yielded for superficial penile tumors as well as for appropriately selected invasive lesions through PSS. The findings suggested a strict follow-up in the early post-operative period.

Methods

• The enrollment consisted of patients treated with PSS from May 1990 to July 2016 at five tertiary referral institutions.
• Treatments included circumcision, wide local excision, laser therapy with or without local excision, partial or total glansectomy, and glans resurfacing.
• Primary endpoint constituted the local recurrence free survival (LRFS), defined from initial treatment to time of local recurrence and computed with the Kaplan-Meier method.

Results

• The enrollees included 1,188 patients.
• Over a median follow-up of 43.0 months, 252 (21.2%) local recurrences were reported with 39.3% (99/252) occurring in the first year.
• It was noted that the median time to local recurrence was 16.3 months and the 5-year LRFS was 73.6%.
• The 5-yr LRFS were 75.0%, 71.4%, and 75.9% for Ta/Tis, T1, and T2 cases, respectively (log-rank p=0.748), when stratified by stage.
• Maximum (58.3%) of recurrences underwent repeat organ sparing procedures.
• The secondary partial (total) penectomy rate was determined to be 19.0%.
• Only margin status exhibited a marked connection with a local recurrence on multivariate analysis (p=0.001).
• Retrospective design and heterogeneous clinical approach served as the limitations.