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[Systemic therapy of penile cancer].

Penile cancer is a rare tumor in Europe with an incidence of 0.1-0.9 per 100,000 men per year. The success of our therapy is mainly influenced by the presence of lymph node metastases. At first diagnosis 17-45% of patients already harbor lymph node metastases. Bilateral inguinal and pelvic lymphadenectomy is a curative measure in these patients. In cases of gross inguinal metastases neoadjuvant chemotherapy leads to a remission rate of 21-60% and improves the resectability. The influence on survival is not proven. The same holds true for adjuvant therapy following lymphadenectomy. Polychemotherapy rarely leads to long-lasting complete remission in patients with distant metastases. The protocols consist usually of cisplatin, bleomycin, methotrexate, and 5-fluorouracil. The overall remission rate is around 15-32%. Because of the low efficacy of the present chemotherapy regimens, one should follow new strategies, comparable to those initiated for squamous cell cancer of other organs.