TY - JOUR
T1 - Adherence to EAU guidelines on penile cancer translates into better outcomes
T2 - a multicenter international study
AU - Cindolo, Luca
AU - Spiess, Philippe E.
AU - Bada, Maida
AU - Chipollini, Juan J.
AU - Nyirády, Peter
AU - Chiodini, Paolo
AU - Varga, Judith
AU - Ditonno, Pasquale
AU - Battaglia, Michele
AU - De Nunzio, Cosimo
AU - Tema, Giorgia
AU - Veccia, Alessandro
AU - Antonelli, Alessandro
AU - Musi, Gennaro
AU - De Cobelli, Ottavio
AU - Conti, Andrea
AU - Micali, Salvatore
AU - Álvarez-Maestro, Mario
AU - Olarte, José Quesada
AU - Diogenes, Erico
AU - Lima, Marcos Venicio Alves
AU - Tracey, Andrew
AU - Guruli, Georgi
AU - Autorino, Riccardo
AU - Sountoulides, Petros
AU - Schips, Luigi
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Introduction: We aimed to evaluate adherence to the EAU guidelines (GL) on penile cancer (PC) with regard to primary surgical treatment and management of lymph nodes and to estimate the influence of adherence to GL on clinical outcome. Materials and methods: This is a retrospective multicenter study (PEnile Cancer ADherence study, PECAD Study) on PC patients treated at 12 European and American centers between 2010 and 2016. Adherence to the EAU GL on the surgical management of the primary penile tumor and lymphadenectomy was evaluated. Descriptive analyses were performed, and survival curves were estimated. Results: Data on 425 patients were considered for the analysis. The EAU GL on surgical treatment of the primary tumor and lymphadenectomy were respected in 74.8% and 73.7% of cases, respectively. Survival analysis showed that adherence to the GL on primary penile surgery was significantly associated with a good overall survival [adjusted HR 0.40 (95% CI 0.20–0.83, p value = 0.014)]. Also, the adherence to the GL on lymphadenectomy was statistically significantly associated with overall survival [adjusted HR 0.48 (95% CI 0.24–0.96, p value = 0.038)]. Limited follow-up and retrospective design represent limitations of this study. Conclusions: Our findings suggest that there is a good adherence to the EAU GL on PC. However, this should be further reinforced, endorsed and encouraged as it might translate into better clinical outcomes for PC patients.
AB - Introduction: We aimed to evaluate adherence to the EAU guidelines (GL) on penile cancer (PC) with regard to primary surgical treatment and management of lymph nodes and to estimate the influence of adherence to GL on clinical outcome. Materials and methods: This is a retrospective multicenter study (PEnile Cancer ADherence study, PECAD Study) on PC patients treated at 12 European and American centers between 2010 and 2016. Adherence to the EAU GL on the surgical management of the primary penile tumor and lymphadenectomy was evaluated. Descriptive analyses were performed, and survival curves were estimated. Results: Data on 425 patients were considered for the analysis. The EAU GL on surgical treatment of the primary tumor and lymphadenectomy were respected in 74.8% and 73.7% of cases, respectively. Survival analysis showed that adherence to the GL on primary penile surgery was significantly associated with a good overall survival [adjusted HR 0.40 (95% CI 0.20–0.83, p value = 0.014)]. Also, the adherence to the GL on lymphadenectomy was statistically significantly associated with overall survival [adjusted HR 0.48 (95% CI 0.24–0.96, p value = 0.038)]. Limited follow-up and retrospective design represent limitations of this study. Conclusions: Our findings suggest that there is a good adherence to the EAU GL on PC. However, this should be further reinforced, endorsed and encouraged as it might translate into better clinical outcomes for PC patients.
KW - Guidelines
KW - Lymphadenectomy
KW - Partial penectomy
KW - Penile cancer
KW - Survival
KW - Total penile amputation
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U2 - 10.1007/s00345-018-2549-3
DO - 10.1007/s00345-018-2549-3
M3 - Article
C2 - 30377813
AN - SCOPUS:85055740559
SN - 0724-4983
VL - 37
SP - 1649
EP - 1657
JO - World Journal of Urology
JF - World Journal of Urology
IS - 8
ER -