Adherence to EAU guidelines on penile cancer translates into better outcomes: a multicenter international study

Luca Cindolo, Philippe E. Spiess, Maida Bada, Juan J. Chipollini, Peter Nyirády, Paolo Chiodini, Judith Varga, Pasquale Ditonno, Michele Battaglia, Cosimo De Nunzio, Giorgia Tema, Alessandro Veccia, Alessandro Antonelli, Gennaro Musi, Ottavio De Cobelli, Andrea Conti, Salvatore Micali, Mario Álvarez-Maestro, José Quesada Olarte, Erico DiogenesMarcos Venicio Alves Lima, Andrew Tracey, Georgi Guruli, Riccardo Autorino, Petros Sountoulides, Luigi Schips

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1649-1657
Number of pages9
JournalWorld Journal of Urology
Issue number8
Publication statusPublished - Aug 1 2019


  • Guidelines
  • Lymphadenectomy
  • Partial penectomy
  • Penile cancer
  • Survival
  • Total penile amputation

ASJC Scopus subject areas

  • Urology


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