Penile Squamous Cell Carcinoma with Pelvic Lymphadenopathy or Fixed Inguinal Nodal Mass (cN3) — Treatment in Cisplatin-Eligible Patients
Clinical Scenario
This protocol applies to patients with penile squamous cell carcinoma who present with a fixed inguinal nodal mass or pelvic lymphadenopathy — unilateral or bilateral — classified as clinical stage cN3, and who are fit for cisplatin-based chemotherapy. The presence of pelvic lymph node involvement is a key determinant of the treatment pathway at this stage.
Treatment Approach (Overview — Partial)
Following surgical management, the approach in this setting involves adjuvant radiotherapy — with or without chemosensitisation — as a central component, with the role of adjuvant chemotherapy further shaped by pathological nodal findings at the pelvic level. The full sequencing, eligibility criteria, and complete regimen are available in the structured protocol below.
References
- cN3 Fixed inguinal nodal mass or pelvic lymphadenopathy, unilateral or bilateral.
- Offer neoadjuvant chemotherapy using a cisplatin- and taxane-based combination to chemotherapy-fit patients with pelvic lymph node involvement or those with extensive inguinal involvement (cN3), in preference to upfront surgery.
- Offer adjuvant radiotherapy (with or without chemosensitisation) to patients with pN2/N3 disease, including those who received prior neoadjuvant chemotherapy.
- Have a balanced discussion of risks and benefits of adjuvant chemotherapy with high-risk patients with surgically resected disease, in particular with those with pathological pelvic LN involvement (pN3).
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