Login to Access Video or Poster Abstract: MP80-01
Sources of Funding: none

Introduction

Local recurrence rate of penile cancer following surgical excision is reported in many series to be between 6 and-29%. Intra-operative Frozen Section (FS) is a useful tool to ensure safe microscopic margins in organ sparing procedures in penile cancer. In this series, we evaluated the impact of intra-operative surgical margin assessment by FS examination during penile-cancer preserving surgery on the local recurrence rate.

Methods

We analysed all those patients in which intra-operative FS was employed during penile preserving surgery in a single tertiary referral centre (catchment of 6.5 million) from 2007-2014. The tissue analysed for margins was the Urethral “donut�, corporal and/or glandular tissue proximal to the resection margin. We looked to see if this technique altered the surgical technique and what affect it had on recurrence rates. Median follow-up was 28 (1-114) months.

Results

Of the total number of 93 patients, 39 (41.9%) had a total glansectomy, 44 (47.3%) a partial penectomy, 7 (7.5%) a wide local excision, 2 (2.2%) a total penectomy and one (1%) a circumcision. Intra-operative histological FS examination of the surgical margin was positive in 16 (17.2%) cases mandating further resection under the same anaesthetic. Final paraffin histological examination confirmed cancer-free margins in 100%. At follow-up, none of the 16 patients with initial positive FS had local recurrence. Only 1 (1%) patient with negative intra-operative FS developed local recurrence at 23 months. This patient’s histology was initially G3pT4.

Conclusions

The use of intra-operative frozen section analysis during organ preserving surgery for penile cancer facilitates conservative surgery, reduces the need, distress and expense of further surgery and in this series contributed to a very low rate (1%) of local recurrence.

Funding

none