Partial or total penectomy with a negative surgical margin remains the gold standard in managing invasive penile cancer, but less invasive options that may improve quality of life are being considered based on tumor stage and grade, according to new clinical practice guidelines from the National Comprehensive Cancer Network and published in the Journal of the National Comprehensive Cancer Network (2013;11:659-662). 

Alternatives include topical treatment with either imiquimod 5% or 5-fluorouracil cream, or wide local excision with circumcision.

Laser therapy and complete glansectomy are also appropriate in specific circumstances.

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