Mohs Micrographic Surgery for Penile Squamous Cell Carcinoma: A Systematic Review.
Jonathan D Greenzaid, Ainsley J Ruley, Kelly M Kimball et al.
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In 30 seconds
This systematic review assessed clinical outcomes and complications of Mohs micrographic surgery (MMS) for penile squamous cell carcinoma. Nineteen studies covering 329 tumors were included. Reported outcomes were uncommon: local recurrence occurred in 5%, nodal metastasis in 3%, distant metastasis in 0.3%, and disease-specific death in 1%. Advanced-stage tumors had more local recurrence than early-stage tumors (8% vs 1%), while reported nodal and distant metastasis rates were similar. Complications occurred in 9%. The authors describe MMS as a penis-sparing option, particularly for low-stage disease, while noting that the evidence base is low-level.
Key findings
- Across 329 tumors, local recurrence was 5%, nodal metastasis 3%, distant metastasis 0.3%, and disease-specific death 1%.
- Local recurrence was higher for T2/T3 than Tis/T1 tumors (8% vs 1%); nodal rates were 2% vs 1% and distant rates 0% vs 1%.
- Complications occurred in 9%, including poor wound healing and urethral stricture, each reported in 3%.
Why it matters
Penectomy can be disfiguring and cause psychosocial distress, so tissue-preserving approaches are clinically relevant. This review summarizes reported cancer outcomes and surgical complications after MMS, suggesting low recurrence rates in low-stage tumors. Its findings also highlight the need to consider tumor stage and potential urethral or reconstructive involvement when assessing this approach.
What to keep in mind
The review reports that the evidence level was low; its findings are based on 19 included studies.