Penile cancer is a rare disease but has a significant impact on quality of life. Its incidence is increasing, so it is important to include new and relevant evidence in clinical practice guidelines.
To provide a collaborative guideline that offers worldwide physician and patient guidance for the management of penile cancer.
Comprehensive literature searches were performed for each section topic. In addition, three systematic reviews were conducted. Levels of evidence were assessed, and a strength rating for each recommendation was assigned according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology.
Penile cancer is a rare disease but its global incidence is increasing. Human papillomavirus (HPV) is the main risk factor for penile cancer and pathology should include an assessment of HPV status. The main aim of primary tumour treatment is complete tumour eradication, which has to be balanced against optimal organ preservation without compromising oncological control. Early detection and treatment of lymph node (LN) metastasis is the main determinant of survival. Surgical LN staging with sentinel node biopsy is recommended for patients with a high-risk (≥pT1b) tumour with cN0 status. While (inguinal) LN dissection remains the standard for node-positive disease, multimodal treatment is needed in patients with advanced disease. Owing to a lack of controlled trials and large series, the levels of evidence and grades of recommendation are low in comparison to those for more common diseases.
This collaborative penile cancer guideline provides updated information on the diagnosis and treatment of penile cancer for use in clinical practice. Organ-preserving surgery should be offered for treatment of the primary tumour when feasible. Adequate and timely LN management remains a challenge, especially in advanced disease stages. Referral to centres of expertise is recommended.
Penile cancer is a rare disease that significantly impacts quality of life. While the disease can be cured in most cases without lymph node involvement, management of advanced disease remains challenging. Many unmet needs and unanswered questions remain, underlining the importance of research collaborations and centralisation of penile cancer services.
European urology. 2023 Mar 07 [Epub ahead of print]
Oscar R Brouwer, Maarten Albersen, Arie Parnham, Chris Protzel, Curtis A Pettaway, Benjamin Ayres, Tiago Antunes-Lopes, Lenka Barreto, Riccardo Campi, Juanita Crook, Sergio Fernández-Pello, Isabella Greco, Michiel S van der Heijden, Peter A S Johnstone, Mithun Kailavasan, Kenneth Manzie, Jack David Marcus, Andrea Necchi, Pedro Oliveira, John Osborne, Lance C Pagliaro, Herney A Garcia-Perdomo, R Bryan Rumble, Ashwin Sachdeva, Vasileios I Sakalis, Łukasz Zapala, Diego F Sánchez Martínez, Philippe E Spiess, Scott T Tagawa
The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: ., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Department of Urology, The Christie NHS Foundation Trust, Manchester, UK., Helios Clinics Schwerin, Schwerin, Germany., The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Urology, St George's University Hospitals NHS Foundation Trust, London, UK., Department of Urology, Hospital de S. João, Porto, Portugal., Department of Urology, University Hospital Nitra, Nitra, Slovakia., Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, San Luca Nuovo, Florence, Italy., British Columbia Cancer Agency, University of British Columbia, Kelowna, Canada., Department of Urology, Cabueñes University Hospital, Gijón, Spain., Department of Urological Minimally Invasive and Robotic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy., Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Departments of Radiation Oncology and Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA., Nottingham City Hospital, Nottingham, UK., Orchid, London, UK., Multicancer Fighter Patient Advocate, Us TOO, New York, NY, USA., Department of Urology and Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Department of Pathology, The Christie NHS Foundation Trust, Manchester, UK; Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trásos-Montes and Alto Douro, Vila Real, Portugal; Veterinary Sciences Department, University of Trásos-Montes and Alto Douro, Vila Real, Portugal., Department of Oncology, Mayo Clinic, Rochester, MN, USA., Division of Urology/Uro-oncology, Department of Surgery, School of Medicine, Universidad Del Valle, Cali, Colombia., American Society of Clinical Oncology, Alexandria, VA, USA., Division of Cancer Sciences, University of Manchester, Manchester, UK., Department of Urology, Agios Pavlos General Hospital, Thessaloniki, Greece., Department of Urology, Medical University of Warsaw, Warsaw, Poland., Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, Asuncion, Paraguay., Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Division of Hematology and Medical Oncology, Weill Cornell Medical College, New York, NY, USA.