... and occurs almost exclusively in uncircumcised men. It presents most commonly in men in their third and fourth decades. The exact etiology remains unclear, but is thought to be multifactoral. ... 80–90%. However, in the presence of lymph node metastases, this is reduced to 20–40%. 18 Management of involved lymph nodes Delay in assessment and diagnosis of penile cancer can often ... techniques, in conjunction with dynamic sentinel lymph node sampling, has dramatically improved the management of this rare malignancy, with more acceptable cosmetic and functional results, as well...