Proposing a new CT surveillance protocol for node positive squamous cell carcinoma of the penis.
BAUS ePoster online library. Ager M. Jun 24, 2019; 259529; P4-14
Mr. Michael Ager
Mr. Michael Ager
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Evidence for best practice follow up of node positive SCC of the penis (SCCp) is scant. Our practice mirrors EAU guidelines; 3 monthly review CT (TAP) for 2 years and 6 monthly for years 3-5. We aim to determine optimum frequency and duration of CT TAP and length of follow up based on site and timing of first regional or distant recurrence.


A prospective database of all penile cancer patients treated at our centre from 2002-2017 was reviewed. We compared nodal pathological stage (TNM 7) to site and time of first recurrence. Surveillance time was defined from completion nodal surgery.


Of 1019 new SCCp, 224 were node positive with full follow up data; pN1 (48), pN2 (33) and pN3 (143). 6 pN1 patients had recurrence, (range 1-11 months). 10 pN2 patients had recurrence (range 0 - 12 months). 84 pN3 patients had recurrence (66 in year 1, 14 in year 2, 2 in years 3-5). Site of first recurrence was inguinal basin 21%, pelvis 28%, chest 31%, 20% all other sites.


Regional and distant recurrence was not observed in pN1 and pN2 after 12 months. 97% of pN3 did not relapse after 24 months. Sites of recurrence supports CT TAP as the optimum imaging modality. We propose a new CT TAP surveillance protocol of 2 years for pN1 and pN2 patients; 3 monthly scans for the first year and 6 monthly for the second and a further year for pN3. Patients could then be safely discharged.
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