2026/03/23 by Mohamed Eldaneen, James Bedford, Duncan Wagstaff +3 · 1 voice
Economics, Econometrics and Finance · Medicine · #Cancer #Disease #Diverse Scientific and Economic Studies #Inguinal lymph nodes #Legal Cases and Commentary #Medical and Biological Sciences #Multidisciplinary approach #Penectomy #Penile cancer #Perioperative #Quality of life (healthcare)
paper · doi:10.14324/111.444/apoc.3713
openalex publication_date 2026/03/23 · openalex created_date 2026/03/24 · openalex updated_date 2026/06/11
Penile cancer in frail, elderly patients presents a complex management challenge requiring careful balance between oncological outcomes, functional outcomes and individual perioperative factors. This clinical vignette illustrates a typical delayed presentation in a 78-year-old man with significant comorbidities and frailty, resulting in locally advanced disease with inguinal lymph node metastasis. While total penectomy and lymph node dissection offers the highest chance of local control, this scenario underscores the critical need for a multidisciplinary approach. Key considerations include accurate staging and thorough perioperative optimisation of cardiac, anticoagulation and metabolic status. Ultimately, decision-making must extend beyond tumour staging to integrate geriatric assessment, shared decision-making and patient values regarding quality of life, functional outcomes and recovery burden. A multidisciplinary approach is essential to align aggressive cancer surgery with the realities of frailty and comorbidity, ensuring that treatment is both medically appropriate and personally acceptable.