We are studying advanced penile cancer to help decide the best treatment options. This phase III study (a late stage of testing) involves patients with cancer that has spread to the groin area. The study uses a Bayesian design (a way to analyze data more flexibly) to answer important treatment questions. Patients are divided into groups based on the size of their cancer. Each group gets a different treatment plan. Options include surgery alone, or surgery after chemotherapy (cancer-fighting drugs) or chemoradiotherapy (combination of chemotherapy and radiation). After surgery, some may get extra treatment if their cancer is likely to come back.

• The study requires random assignment to different treatments.
• You must have advanced penile squamous cell carcinoma to participate.
• Patients need to give written consent and meet specific health criteria.