Glansectomy and Reconstruction for Penile Cancer: A Systematic Review

Abstract

Penile cancer (PeCa) is a rare disease, with a global incidence of 36 068 new cases reported in the 2020 GLOBOCAN database. Narrower excision margins are now acceptable without compromising survival. Glansectomy is commonly performed for invasive PeCa confined to the glans penis. The majority of data on glansectomy are from small single-centre series. We provide a contemporary update on the outcomes of glansectomy via a systematic review of glansectomy for PeCa. Overall, 20 studies were included in the analysis. The local recurrence rate was 2.6–16.7%. The incidence of salvage penectomy for positive margins and/or recurrence was 1.2–8.3%. The disease-specific survival rate was 89–96.6%. A split-thickness skin graft was commonly used to reconstruct a neoglans and the graft loss rate was 1.5–23.5%. The incidence of meatal stenosis was 2.8–14.3%. Good cosmetic outcomes and normal erections were reported in 95–100% and 50–100% of cases, respectively. Glansectomy provides acceptable oncological control without significantly compromising functional outcomes. Patient summary: Penile cancer invading into the head of the penis can be surgically treated with a procedure called glansectomy that has good cancer control and cosmetic outcomes. In addition, penile length can be preserved, which allows men to urinate standing up and to achieve penetrative sexual intercourse.