Treatment of T1–T2 Penile Squamous Cell Carcinoma Confined to the Glans and Prepuce
When invasive penile squamous cell carcinoma is staged T1 or T2 and anatomically limited to the glans and prepuce, current evidence supports organ preservation as the central treatment goal for suitable patients.
Clinical scenario
T1 or T2 penile squamous cell carcinoma confined to the glans and prepuce. This represents invasive disease at the cT1/T2 stage in which tumour extent and location allow organ-sparing strategies to be considered, provided the patient is willing to comply with strict follow-up.
Treatment approach — partial overview
Management centres on organ-sparing surgical or non-surgical interventions, with the appropriate modality determined by tumour location, size, and stage.
Full structured regimen, criteria, and evidence base available below ↓
References
- Treatment of invasive disease confined to the glans (cT1/T2).
- Offer organ-sparing surgery and reconstructive techniques to patients with lesions confined to the glans and prepuce (PeIN, Ta, T1–T2) and who are willing to comply with strict follow-up.
- Foreskin tumours are treated by 'radical' circumcision.
- For glandular and coronal lesions, wide local excision, partial glansectomy or total glansectomy with reconstruction are surgical options, while additional circumcision is advised in glandular tumours.
- Radiotherapy can be given as external radiotherapy with a minimum dose of 60Gy EQD2, combined with a brachytherapy boost or as brachytherapy alone.
- Brachytherapy has been studied only for lesions < 4 cm, therefore, its use should be limited to tumours not exceeding this size.
- Offer radiotherapy to selected patients with biopsy-confirmed T1 or T2 lesions.
- Offer laser ablation using carbon dioxide or Neodymium:Yttrium-Aluminium-Garnet laser to patients with biopsy-confirmed PeIN, Ta or T1 lesions.
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