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

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.

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.

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.

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.

World journal of urology. 2018 Oct 30 [Epub ahead of print]

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 Alvarez Maestro, José Quesada Olarte, Erico Diogenes, Marcos Venicio Alves Lima, Andrew Tracey, Georgi Guruli, Riccardo Autorino, Petros Sountoulides, Luigi Schips

Department of Urology, ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy. ., Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA., Department of Urology, ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy., Department of Urology, Hospital of Budapest, Budapest, Hungary., Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Naples, Italy., Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy., Department of Urology, Hospital "Sant' Andrea", Sapienza University, Rome, Italy., Department of Urology, Hospital "Spedali Civili", Brescia, Italy., Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy., Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Department of Urology, Hospital Universitario La Paz, Madrid, Spain., Department of Urology, Ceara Cancer Institute, Fortaleza, Brazil., Department of Urology, Virginia Commonwealth University, Richmond, VA, USA., Department of Urology, General Hospital of Veria, Veria, Greece., Department of Urology, "G.D'Annunzio" University, Chieti, Italy.