(UroToday.com) To discuss aggressive surgical approaches for primary tumors, Dr. Chris Protzel joined the inaugural Global Society of Rare Genitourinary Tumors (GSRGT) 2020 Virtual Summit. Dr. Protzel notes that treatment of the primary tumor is the key to quality of life for these patients. Barriers to treatment of the primary tumor include fear (30%), social problems (35%), psychiatric problems (>50%), and sexual function concerns (77%). In line with these concerns, the National Comprehensive Cancer Network (NCCN) guidelines suggest that careful consideration should be given to penile-preserving techniques if the patient is reliable in terms of compliance and close follow-up. These techniques may include wide local excision, as well as Mohs surgery (plus reconstructive surgery) and laser therapy. Local recurrence after primary organ sparing surgery varies from 4-56% for patients with T1 disease and 4-34% for patients with T2 tumors: