Das Peniskarzinom – eine Herausforderung für die moderne Uro-Onkologie

Zusammenfassung

Die Datenlage zur Therapie des Peniskarzinoms ist aufgrund der geringen Inzidenz in Europa und Nordamerika sowie einer dezentralisierten Therapie ausgesprochen unbefriedigend. Dennoch lassen sich in den letzten Jahren deutliche Fortschritte insbesondere bei der Therapie des Primärtumors erkennen. Hier kommt dem organerhaltenden Vorgehen bei frühen Tumorstadien eine größere Bedeutung zu. Das Lymphknotenmanagement spielt eine entscheidende Rolle für eine kurative Therapie des Peniskarzinoms. Ein invasives Lymphknotenstaging sollte auch bei Patienten mit nichtpalpablen inguinalen Lymphknoten ab dem Tumorstadium pT1G2 erfolgen. Für Patienten mit großen und/oder fixierten inguinalen Lymphknotenmetastasen erscheint die Option einer neoadjuvanten Chemotherapie mit nachfolgender Salvage-Lymphadenektomie erfolgversprechend. Aufgrund aktueller Studienergebnisse sollte der Einsatz von Cisplatin/Taxan basierten Chemotherapieprotokollen erfolgen.

Abstract

Due to the low incidence of penile cancer in Europe and North America and often decentralised patient management, data on the treatment of penile cancer are very rare. Nevertheless, recently relevant data have become available for the improvement of the therapy especially for the primary tumours. Penile conserving surgery is becoming more important for early tumour stages. The management of lymph nodes plays a key role for the successful treatment of patients with penile cancer. An invasive lymph node staging is recommended for all patients with primary pT1G2 or higher tumours. Neoadjuvant chemotherapy followed by salvage lymphadenectomy has shown promising results in patients with large and/or fixed inguinal lymph node metastases. Due to the results of recent studies, cisplatin/taxan-based chemotherapy regimens have to be recommended.

Schlüsselwörter

Peniskarzinom - Lymphknotenmetastasen - Chemotherapie

Key words

penile cancer - lymph node metastases - chemotherapy

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