Adherence to the EAU guidelines on Penile Cancer Treatment: European, multicentre, retrospective study

Maida Bada, Francesco Berardinelli, P. Nyírády, Judith Varga, Pasquale Ditonno, Michele Battaglia, Paolo Chiodini, Cosimo De Nunzio, Giorgia Tema, Alessandro Veccia, Alessandro Antonelli, Luca Cindolo, Claudio Simeone, Stefano Puliatti, Salvatore Micali, Luigi Schips

Research output: Article

Abstract

Purpose: The European Association of Urology (EAU) guidelines for penile cancer (PC) are exclusively based on retrospective studies and have low grades of recommendation. The aim of this study was to assess the adherence to guidelines by investigating the management strategies for primary tumours and inguinal lymph nodes. Methods: We retrospectively reviewed the clinical charts of 176 PC patients who underwent surgery in eight European centres from 2010 to 2016. The stage and grade were assessed according to the 2009 AJCC–UICC TNM classification system. To assess adherence rates, we compared theoretical and practical adherence to the EAU guidelines. Results: Overall, 176 patients were enrolled. Partial amputation was the most frequent surgical approach (39%). 53.7% of tumours were stage Tis-T1b and the remaining 46.3% were stage T2-T4. Palpable lymph nodes were detected in 30.1% of patients and 45.1% underwent lymphadenectomy (LY). A sizeable group of tumours (43.2%) were N0. For primary treatment, adherence to the EAU guidelines was good (66%). In non-adherent cases, reasons for discrepancy were patient’s choice (17%), surgeon’s preference (36%), and other causes (47%). For LY, the guideline adherence was 70%, with either patient’s or surgeon’s choice or other causes accounting for discrepancy in 28, 20, and 52% of non-adherent cases, respectively. Conclusion: Adherence to the EAU guidelines for PC was quite high across the eight European centres involved in the study. This notwithstanding, strategies for further improvement should be developed and evenly adopted.

Original languageEnglish
Pages (from-to)921-926
Number of pages6
JournalJournal of cancer research and clinical oncology
Volume145
Issue number4
DOIs
Publication statusPublished - ápr. 2 2019

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Penile Neoplasms
Urology
Multicenter Studies
Retrospective Studies
Guidelines
Guideline Adherence
Lymph Node Excision
Lymph Nodes
Therapeutics
Neoplasms
Groin
Neoplasm Staging
Amputation

Keywords

    ASJC Scopus subject areas

    • Oncology
    • Cancer Research

    Cite this

    Adherence to the EAU guidelines on Penile Cancer Treatment : European, multicentre, retrospective study. / Bada, Maida; Berardinelli, Francesco; Nyírády, P.; Varga, Judith; Ditonno, Pasquale; Battaglia, Michele; Chiodini, Paolo; De Nunzio, Cosimo; Tema, Giorgia; Veccia, Alessandro; Antonelli, Alessandro; Cindolo, Luca; Simeone, Claudio; Puliatti, Stefano; Micali, Salvatore; Schips, Luigi.

    In: Journal of cancer research and clinical oncology, Vol. 145, No. 4, 02.04.2019, p. 921-926.

    Research output: Article

    Bada, M, Berardinelli, F, Nyírády, P, Varga, J, Ditonno, P, Battaglia, M, Chiodini, P, De Nunzio, C, Tema, G, Veccia, A, Antonelli, A, Cindolo, L, Simeone, C, Puliatti, S, Micali, S & Schips, L 2019, 'Adherence to the EAU guidelines on Penile Cancer Treatment: European, multicentre, retrospective study' Journal of cancer research and clinical oncology, vol. 145, no. 4, pp. 921-926. https://doi.org/10.1007/s00432-019-02864-9
    Bada, Maida ; Berardinelli, Francesco ; Nyírády, P. ; Varga, Judith ; Ditonno, Pasquale ; Battaglia, Michele ; Chiodini, Paolo ; De Nunzio, Cosimo ; Tema, Giorgia ; Veccia, Alessandro ; Antonelli, Alessandro ; Cindolo, Luca ; Simeone, Claudio ; Puliatti, Stefano ; Micali, Salvatore ; Schips, Luigi. / Adherence to the EAU guidelines on Penile Cancer Treatment : European, multicentre, retrospective study. In: Journal of cancer research and clinical oncology. 2019 ; Vol. 145, No. 4. pp. 921-926.
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    AU - Bada, Maida

    AU - Berardinelli, Francesco

    AU - Nyírády, P.

    AU - Varga, Judith

    AU - Ditonno, Pasquale

    AU - Battaglia, Michele

    AU - Chiodini, Paolo

    AU - De Nunzio, Cosimo

    AU - Tema, Giorgia

    AU - Veccia, Alessandro

    AU - Antonelli, Alessandro

    AU - Cindolo, Luca

    AU - Simeone, Claudio

    AU - Puliatti, Stefano

    AU - Micali, Salvatore

    AU - Schips, Luigi

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    N2 - Purpose: The European Association of Urology (EAU) guidelines for penile cancer (PC) are exclusively based on retrospective studies and have low grades of recommendation. The aim of this study was to assess the adherence to guidelines by investigating the management strategies for primary tumours and inguinal lymph nodes. Methods: We retrospectively reviewed the clinical charts of 176 PC patients who underwent surgery in eight European centres from 2010 to 2016. The stage and grade were assessed according to the 2009 AJCC–UICC TNM classification system. To assess adherence rates, we compared theoretical and practical adherence to the EAU guidelines. Results: Overall, 176 patients were enrolled. Partial amputation was the most frequent surgical approach (39%). 53.7% of tumours were stage Tis-T1b and the remaining 46.3% were stage T2-T4. Palpable lymph nodes were detected in 30.1% of patients and 45.1% underwent lymphadenectomy (LY). A sizeable group of tumours (43.2%) were N0. For primary treatment, adherence to the EAU guidelines was good (66%). In non-adherent cases, reasons for discrepancy were patient’s choice (17%), surgeon’s preference (36%), and other causes (47%). For LY, the guideline adherence was 70%, with either patient’s or surgeon’s choice or other causes accounting for discrepancy in 28, 20, and 52% of non-adherent cases, respectively. Conclusion: Adherence to the EAU guidelines for PC was quite high across the eight European centres involved in the study. This notwithstanding, strategies for further improvement should be developed and evenly adopted.

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    KW - Lymphadenectomy

    KW - Partial amputation

    KW - Penile cancer

    KW - Total amputation

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