NCCN has published updates to theNCCN Guidelines® and NCCN Compendium® for Penile Cancer.

• FLASCO
• January 12, 2017
• Clinical Practice Updates, News

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium^®) for Penile Cancer. These NCCN Guidelines^® are currently available as Version 1.2017.

• Primary treatment
  • Tis or Ta disease (PN-1)
    • The second option was revised: “Wide local excision .”
    • The fifth option was added: “Mohs surgery in select cases (category 2B).”
  • T1, grade 1-2 (PN-2)
    • The second option was added: “Glansectomy in select cases.”
    • The third option was added: “Mohs surgery in select cases (category 2B).”
  • T1, grade 3-4 (PN-2)
    • The option of “glansectomy” was removed.
  • Management of palpable non-bulky inguinal lymph node (PN-4)
    • For unilateral lymph node(s) <4 cm (mobile) and high-risk primary lesions, treated with ILND, the options for pN2-3 disease were revised by adding: “Pelvic lymph node dissection (PLND) ± adjuvant chemotherapy or chemoradiotherapy (category 2B).”
  • Local recurrence in inguinal region (PN-8)
    • The treatment algorithm was revised extensively.
  • Principles of Penile Organ-Sparing Approaches (PN-A)
    • For the topical therapies, imiquimod 5% and 5-FU cream 5%, dosing was added.
    • For laser therapy, new information was added along with a table of the therapeutic lasers commonly used to treat penile cancer including suggested settings.
  • Principles of Surgery (PN-B)
    • This section was revised extensively.
  • Principles of Radiotherapy (PN-C)
    • For primary radiation/chemoradiation therapy of T1-2, N0 disease, tumor <4 cm, the qualifier “preferred approach” was removed from “brachytherapy alone” and clarified as a category 2B recommendation.
    • EBRT was clarified as a category 2B recommendation and EBRT with concurrent chemotherapy was clarified as a category 3 recommendation.
  • Principles of Chemotherapy (PN-D)
    • For neoadjuvant chemotherapy prior to ILND or PLND, the first bullet was revised from “neoadjuvant, cisplatin-based chemotherapy…” to “neoadjuvant chemotherapy with TIP (paclitaxel, ifosfamide, and cisplatin)…”
    • For adjuvant chemotherapy following ILND or PLND, the first bullet was revised by adding: “5-FU plus cisplatin can be considered as an alternative to TIP in the adjuvant setting.”
    • For the regimen, 5-FU + cisplatin, the dosing was updated and a qualifier was added: “not recommended for neoadjuvant setting.

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium^®, the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients^®, please visit NCCN.org/patients.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.