Surgical Outcomes of Glansectomy and Split Thickness Skin Graft Reconstruction for Localized Penile Cancer

• Published in: Urology (Ridgewood, N.J.) N.J.), 2021-06, Vol.152, p.195-195
• Main Authors: Falcone, Marco, Oderda, Marco, Calleris, Giorgio, Peretti, Federica, Gontero, Paolo
• Format: Article
• Language: English
• Subjects: Disease-Free Survival; Follow-Up Studies; Humans; Incidence; Male; Margins of Excision; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Organ Sparing Treatments - adverse effects; Organ Sparing Treatments - methods; Penile Neoplasms - mortality; Penile Neoplasms - pathology; Penile Neoplasms - surgery; Penis - pathology; Penis - surgery; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Retrospective Studies; Skin Transplantation - adverse effects; Skin Transplantation - methods; Urologic Surgical Procedures, Male - adverse effects; Urologic Surgical Procedures, Male - methods
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2021.03.022

The management of localized penile cancer is based on organ-sparing approaches. Our aim is to report surgical outcomes of glansectomy (GS) and split thickness skin graft (STSG) reconstruction in a consecutive series of penile cancers. Patients with a localized penile cancer underwent GS and STSG reconstruction in tertiary referral center. Data were extrapolated from a single center prospective database starting from May 2013 to August 2019. Two different techniques are presented in the video abstract: - a standard GS with dissection over the Bucks’ fascia. - a salvage GS with dissection under Bucks’ fascia. A total of 34 patients were enrolled. 30 patients underwent a standard GS, whether a salvage GS was performed in the remainders. The apex of corpora cavernosa was transected in 5 cases due to suspicious of local invasion. Median follow-up was 12 (12-41) months. Operative time was 150 (105-180) minutes. Hospital stay was 2 (1-3) days. A modified TODGA compressive dressing and a catheter were applied and left in place for 5 days. After that a saline washing was used for 2 weeks. The incidence of intraoperative complications was minimal (2.9%). Positive surgical margins were detected in 2.9% of cases, requiring a salvage surgery. The incidence of postoperative complications was 29.4%: 11.7% were classified as Grade 1, 8.8% as Grade 2 and 8.8% as Grade 3a according to Clavien-Dindo classification. 1-year recurrence free-survival (RFS) was 88.2%. 1-y cancer-specific (CSS) and overall survival (OS) resulted 91.2% in both cases. Limitations of the study were the retrospective and single centre nature of the study, the lack of comparative group, the limited number of cases and of follow-up. GS and STSG reconstruction represents a safe procedure burden by a low incidence of postoperative complications providing a satisfactory cancer control, with a minimal risk of local recurrence.