E Current Concepts in Penile Cancer

This review highlights the significant advances made in the diagno-sis and management of penile cancer. This often-aggressive tumor phenotype has been characterized by its poor prognosis, mostly attributable to its late presentation and heterogeneity of surgical care because of the paucity of cases treated at most centers. Re-cent advances in understanding of the risk factors predisposing to penile cancer, including its association with the human papilloma virus (HPV), have brought forth the socioepidemiologic concept of HPV vaccination in certain high-risk populations and countries, which remains highly debated. The management of penile cancer has evolved in recent years with the adoption of penile-sparing and minimally invasive surgical approaches to the inguinal lymph nodes, which are a frequent site of regional spread for this malig-nancy. Lastly, this review highlights the importance of adopting a multimodal approach consisting of neoadjuvant systemic chemo-therapy followed by consolidative surgical resection in patients presenting with bulky/locally advanced nodal metastases from pe-nile cancer. (JNCCN 2013;11:617–624