Treatment

♦ Surgical excision with clear margins and removal of groin nodes

♦ Care if tumour involves distal urethra, anal mucosa (preserve function)

♦ Extensive disease may require complex reconstruction

♦ Psychosexual dysfunction, body image problems frequent

♦ Chemo-irradiation for advanced disease: 5 FU and mitomycin C combined with radiotherapy—encouraging results

♦ Bad prognosis if—>3 regional nodes involved

—Stage III, IV disease —large tumour bulk —node metastases —poor performance status —tumour type (melanoma)

♦ Treatment in specialized centres

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