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

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.

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.

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.

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.

Journal of cancer research and clinical oncology. 2019 Mar 01 [Epub ahead of print]

Maida Bada, Francesco Berardinelli, Peter Nyiràdy, 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

Department of Urology, S. Pio da Pietrelcina Hospital, ASL 2 Abruzzo, Vasto, Italy. ., Department of Urology, S. Pio da Pietrelcina Hospital, ASL 2 Abruzzo, Vasto, Italy., Department of Urology, Hospital of Budapest, Budapest, Hungary., Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy., Department of Medical Statistics Unit, Second University, Naples, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Department of Urology, Spedali Civili Hospital, Brescia, Italy., Department of Urology, Baggiovara Hospital, University of Modena and Reggio Emilia, Modena, Italy., Department of Urology, G. D'Annunzio University, Chieti, Italy.