EAU 2014 - Has centralisation of penile cancer services in the United Kingdom improved survival? - Session Highlights

STOCKHOLM, SWEDEN (UroToday.com) - Dr. Ben Ayres and colleagues, from the United Kingdom, presented the outcome of cancer specific survival (CSS) in penile cancer.

In 2001, after the National Institute for Health and Clinical Excellence (NICE) recommendation, the treatment of squamous cell carcinoma penile cancer (SCCp) in UK was centralized. Authors conducted this study to evaluate whether this centralization, in fact, improved CSS in penile cancer in their country. From 2001-2011, 433 patients were treated for SCCp and their data has been prospectively collected. This population was compared to 294 patients who were treated prior to 2001. Since cause of death was not available for all patients in the pre-centralization group, two analyses were performed: the first assuming all patients with no cause of death had died of SCCp and the second assuming none of them had died of SCCp.

eauTaking into account the two analyses for missing causes of death, authors reported that prior to centralization, 1-year CSS was either 89.9% (95% CI: 85.9-92.9%) or 90.3% (86.2-93.2%) and 5-year CSS was 72.7% (66.9-77.7%) or 77.4% (71.8-82.0%). Post centralisation, 1-year CSS was 92.1% (89.4-94.7%) and 5-year CSS was 84.9% (81.2-88.5%). Roughly a 7-12% improvement in 5-year CSS was noted, which likely represents better node detection and management. There was no change in 1-year CSS, which could represent poor overall survival in men with advanced disease at the time of presentation. Over the last several years there have been publications where it has been stated that with centralization of care to high-volume centers, there is less delay in receiving treatment and better cancer outcomes. Authors have shown here that for this rare cancer, over the last decade, the CSS in UK has certainly improved.

Presented by Ben Ayres at the 29th Annual European Association of Urology (EAU) Congress - April 11 - 15, 2014 - Stockholmsmässan - Stockholm, Sweden

St George's Hospital, Department of Urology, London UK

Written by Reza Mehrazin, MD, medical writer for UroToday.com