The clinical and morphologic features of 153 cases of squamous-cell carcinoma of the penis were reviewed. A delay in diagnosis of more than three months occurred in 128 patients (84 per cent) which suggests the need for earlier diagnosis of this condition. Treatment was predominately surgical for the 125 cases in which the disease was clinically confined to the penis (Stage I). Ilioinguinal lymphadenectomies were omitted until clinical suspicion of regional lymphatic spread had occurred. Five- and nine-year survival rates for the patients without clinical evidence of metastatic disease was 64.4 and 50.1 per cent, respectively. These figures are similar to those in other series in which lymphadenectomy is performed initially or on a routine basis, and they support the premise that lymphadenectomy is unwarranted until there is clinical evidence or suspicion of regional lymphatic spread. Treatment for the 24 patients with clinical suspicion or evidence of regional lymphatic spread (Stage II) was varied with five- and nine-year survival rates of only 21.8 per cent.
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