Penile cancer (PeCa) is an orphan disease in European countries. The current guidelines are predominantly based on retrospective studies with a low level of evidence. In our study, we aimed to identify predictors for guideline-conform treatment and hypothesize that reference centers for PeCa and physicians' experience promote guideline compliance and therefore correct local tumor therapy.
This study is part of the European PROspective Penile Cancer Study (E-PROPS), an international collaboration group evaluating therapeutic management for PeCa in Central Europe. For this module, a 14-item-survey was developed and sent to 681 urologists in 45 European centers. Three questions focused on therapeutic decisions for PeCa in clinical stage Tis, Ta-T1a, and T1b. Four questions addressed potential personal confounders. Survey results were analyzed by bootstrap-adjusted stepwise multivariate linear regression analysis to identify predictors for EAU guideline-conform local treatment of PeCa.
For local therapy of cTis 80.4% recommended guideline-conform treatment, for cTa-cT1a 87.3% and for cT1b 59.1%. In total, 42.4% chose a correct approach in all tumor stages. The number of PeCa patients treated at the hospital, a higher level of training of the physicians, resource-based answering and the option of penile-sparing surgery offered at the hospital matched with giving guideline-conform recommendations and thus accurate local tumor treatment.
Patients with PeCa are best treated by experienced physicians, in centers with a high number of cases, which also offer a wide range of local tumor therapy. This could be offered in reference centers.
Advances in therapy. 2020 Oct 10 [Epub ahead of print]
Maximilian Pallauf, Marie C Hempel, Marie C Hupe, Matthias May, Marlene Haccius, Dorothea Weckermann, Steffen Lebentrau, Bernd Hoschke, Ulrike Necknig, Jesco Pfitzenmaier, Lukas Manka, Philipp Nuhn, Peter Törzsök, Lukas Lusuardi, Axel S Merseburger
Department of Urology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria., Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. ., Department of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany., Department of Urology, St. Elisabeth-Hospital Straubing, Straubing, Germany., Department of Urology, University Hospital Augsburg, Augsburg, Germany., Department of Urology, Brandenburg Medical School Theodor Fontane, Ruppiner Kliniken, Neuruppin, Germany., Department of Urology, Carl-Thiem-Clinic Cottbus, Cottbus, Germany., Department of Urology and Pediatric Urology, Garmisch-Partenkirchen Medical Center, Garmisch-Partenkirchen, Germany., Department of Urology, Evangelical Hospital Bethel, Bielefeld, Germany., Clinic of Braunschweig, Braunschweig, Germany., Department of Urology, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.