Department of Urology, S. Pio da Pietrelcina Hospital, ASL 2 Abruzzo, Vasto, Italy.
Department of Urology, Hospital of Budapest, Budapest, Hungary.
J Cancer Res Clin Oncol. 2019 Apr;145(4):921-926. doi: 10.1007/s00432-019-02864-9. Epub 2019 Mar 1.
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.
欧洲泌尿外科学会（EAU）的阴茎癌（PC）指南仅基于回顾性研究，推荐等级较低。本研究旨在通过调查原发性肿瘤和腹股沟淋巴结的治疗策略来评估对指南的遵循情况。
我们回顾性地研究了 2010 年至 2016 年期间在欧洲八个中心接受手术的 176 例 PC 患者的临床病历。根据 2009 年 AJCC-UICC TNM 分类系统评估分期和分级。为了评估遵守率，我们比较了理论上和实际中对 EAU 指南的遵守情况。
共有 176 例患者被纳入研究。部分切除术是最常见的手术方法（39%）。39%的肿瘤为Tis-T1b 期，其余 46.3%为 T2-T4 期。30.1%的患者触及淋巴结，45.1%的患者行淋巴结清扫术（LY）。相当一部分肿瘤（43.2%）为 N0 期。对于原发性治疗，对 EAU 指南的遵守情况较好（66%）。在不遵守的情况下，不遵守的原因是患者选择（17%）、外科医生偏好（36%）和其他原因（47%）。对于 LY，指南的遵守率为 70%，不遵守的原因分别是患者或外科医生的选择或其他原因，占不遵守病例的 28%、20%和 52%。
在所涉及的八个欧洲中心中，对 PC 的 EAU 指南的遵守情况相当高。尽管如此，仍应制定并均匀采用进一步改善的策略。
