Treatment Options and Outcomes for Men with Penile Intraepithelial Neoplasia: A Systematic Review.

Eur Urol Focus

Department of Urology, The Christie NHS Foundation Trust, Manchester, UK; Luzerner Kantonsspital, Luzern, Switzerland. Electronic address:

Published: May 2022

AI Article Synopsis

  • Penile intraepithelial neoplasia (PeIN) is a rare condition that can lead to invasive penile cancer, and a systematic review was conducted to evaluate treatment options.
  • Topical treatments like imiquimod and 5-fluorouracil showed varying response and recurrence rates, with some side effects leading to a 12% discontinuation rate.
  • Surgical options, including circumcision and different excision techniques, had different recurrence rates, underscoring the need for careful monitoring and personalized treatment plans since PeIN can recur or progress.

Article Abstract

Penile intraepithelial neoplasia (PeIN) is a rare skin condition with potential to progress to invasive penile cancer. We performed a systematic review of treatment options and outcomes for PeIN. Topical agents showed response and recurrence rates of 40-100% and 20% for imiquimod, and 48-74% and 11% for 5-fluorouracil, respectively. Discontinuation of topical agents because of side effects was observed in 12% of cases. Response rates for laser therapies were 52-100%, with recurrence in 7-48% of cases and a change in penile sensitivity in 50%. Circumcision cleared preputial PeIN. Rates of recurrence after surgical treatment of glans PeIN were 25% for wide local excision, 4% for Mohs surgery, 5% for total glans resurfacing, and 10% for glansectomy. There are limited data on factors predictive of treatment response and on sequencing of treatment options. PATIENT SUMMARY: Several treatment options are available for men with precancerous lesions of the foreskin or glans. Close follow-up is necessary as lesions can recur or progress to invasive penile cancer.

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Source
http://dx.doi.org/10.1016/j.euf.2021.04.026DOI Listing

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