Abstract
Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.
| Original language | English |
|---|---|
| Journal | Advances in Therapy |
| Volume | 37 |
| Issue number | 12 |
| Pages (from-to) | 4969-4980 |
| Number of pages | 12 |
| ISSN | 0741-238X |
| DOIs | |
| Publication status | Published - 01.12.2020 |
Funding
We thank the participants of the study. No funding or sponsorship was received for this independent and investigator-initiated study. No Rapid Service or Open Access Fees were received by the journal for the publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. The authors 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 T?rzs?k and Lukas Lusuardi have nothing to disclose. Axel S. Merseburger is an Editorial Board Member of Advances in Therapy. This study was conducted in accordance with the Declaration of Helsinki in its latest version. The survey, its application, and the recruitment letter were submitted to the Institutional Review Board at the University of Regensburg and the project was granted exempt status. The IRB declared that as a survey study for physicians, obtaining information on treatment recommendations for hypothetical patient cases, no written consent is needed and therefore can be waived. The survey did not provide any information about the person completing it, assuring the anonymization of the data. The physicians in every participating medical center were informed about the study and its purpose and agreed that their survey data was being used as part of the study. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Research Areas and Centers
- Research Area: Luebeck Integrated Oncology Network (LION)
DFG Research Classification Scheme
- 2.22-14 Hematology, Oncology
- 2.22-23 Reproductive Medicine, Urology
