Clinical staging of cancer of the penis: by size? By localization? Or by depth of infiltration?

Two hundred and thirty-nine patients with squamous cell carcinoma of the penis were grouped into the existing different clinical classifications and staging systems, i.e. the UICC-TNM (1978 and 1987), Jackson's and that used in Heidelberg. Because of shortcomings observed in the previous systems, a new classification and staging system was developed. The present authors' classification and staging system were found applicable and all patients except 2 with unknown tumor size were classifiable. The distribution into different stages was more even in the proposed staging system than in the previous ones. A good correlation and a gradient for survival rate according to stages were also obtained. We propose that the systems presented should be examined and applied prospectively for clinical classification and staging of carcinoma of the penis.