Results of combined surgical and radiological therapy in penile carcinoma

A retroperspective analysis was made about the results achieved in 64 patients after combined surgical and radiotherapeutic treatment. The tumor areas were irradiated by fast electrons or cobalt 60 with 50 to 55 Gy, the lymph nodes received doses of 45 to 55 Gy. Local tumor control was achieved in 27 out of 28 patients irradiated immediately after surgery (96%). In case of demonstrated lymph node invasion, local control was achieved in 14 out of 19 cases (74%). The median survival was 9.6 years for patients in stage T1/2, N0, M0 and 2.5 years for patients in stage T1-4, N+, M0. The first two years following to therapy were decisive for the prognosis. Among those of our patients who developed recurrences during this period, not one could be cured in the long run. Two years after the end of therapy, the survival probability of patients without lymph node metastases becomes comparable to the survival curve of normal male population of the same age. In the treatment of penile carcinoma, a gradual proceeding depending on the stage is recommended for the combination of surgery and radiotherapy. In case of lymph node metastases, the application of adjuvant chemotherapy should be taken into consideration. (orig.)