Penile cancer. Clinical presentation, diagnosis, and staging.

A high index of suspicion for penile cancer and a low threshold for biopsy of all penile lesions that do not respond to a short trial of conservative therapy are the primary requirements for early diagnosis and treatment of patients with penile cancer. Survival is related to stage; however, there is a considerable difference between clinical and pathologic stage. This discrepancy is attributable to the difficulty in determining corpora cavernosal invasion and inguinal lymph node metastases because of concomitant inflammatory changes and inaccuracies in diagnostic imaging modalities. Aggressive clinical staging may identify otherwise occult tumor and improve locoregional control and survival.