[Organ preservation or radical surgery? Modern surgical concepts within the complex interplay between function and oncology].

Penile cancer is a rare yet highly aggressive urological malignancy, the management of which has undergone a fundamental paradigm shift in recent years. Organ-preserving strategies have gained increasing importance and, particularly in early-stage disease, provide an oncologically safe alternative to radical surgery. This article examines the stage-specific management of the primary tumor, integrating current guideline recommendations, surgical techniques, and functional as well as psychosocial considerations. Special attention is given to the role of intraoperative frozen section analysis, the determination of adequate surgical margins, and the prognostic significance of local recurrence for overall survival. The findings underscore the necessity of individualized, risk-adapted treatment planning within specialized centers.