Carcinoma of the penis is rare, and the prognosis of
penile cancer with inguinal
metastases is extremely poor. Standard
chemotherapy for advanced
penile cancer has not been established because of its rarity. A case of
penile cancer with inguinal
metastases that responded well to
neoadjuvant chemotherapy with
paclitaxel,
ifosfamide and
cisplatin (TIP) is described. A 55-year-old Japanese male visited our hospital for a penile
tumor and fixed, 4 cm, right inguinal lymph nodes. Computed tomography and 18F-FDG-PET imaging showed not only right but also left inguinal
lymphadenopathy.
Penile cancer (clinical stage T3N3M0, 7th edition TNM classification) was diagnosed, and partial penectomy and right inguinal biopsy were performed. The pathological examination revealed
squamous cell carcinoma of the penis with right inguinal
lymph node metastasis. The inguinal
metastases were judged to be unsuitable for radical resection ; and,
paclitaxel 60 mg/m2 (day 1),
ifosfamide 1,200 mg/m2 (days 1-3), and
cisplatin 60 mg/m2 (days 1-3) were given at 3-week intervals as
neoadjuvant chemotherapy. After 4 courses of
chemotherapy, the inguinal
metastases were markedly reduced. He had
neutropenia (grade 3) during each course and
peripheral neuropathy after 2 courses, but there were no severe complications. The patient underwent bilateral inguinal and pelvic
lymphadenectomy after
neoadjuvant chemotherapy. Pathological examination revealed no viable cells in the resected specimens. The patient remains alive and well with no evidence of recurrence 8 months after this radical treatment. TIP
chemotherapy appears to be effective for advanced
penile cancer.