About 25% of men with penile cancer do not receive treatment in accordance with guidelines set forth in 2016 by the European Association of Urology (EAU), scientists report.
The results of their study were presented in March at the annual EAU Congress in Copenhagen, Denmark.
Penile cancer is rare in North America and Europe, representing less than 1% of male cancers in the United States, according to the American Cancer Society. However, it is more common in other parts of the world, including Africa, Asia, and South America.
Treatment for penile cancer may include radiation, chemotherapy, and surgery. The extent of surgery can depend on the size and location of the tumor. A glansectomy removes the glans (tip) of the penis. Other options include partial or total removal of the penis (penectomy). Some men also undergo lymphadenectomy (removal of one or more lymph nodes).
For this study, adherence to EAU guidelines was evaluated for surgery and lymphadenectomy.
Researchers retrospectively examined the medical charts of 425 men who had surgery to treat penile cancer in 12 centers in Europe and North America between 2010 and 2016. For 65% of the men, tumors were located on the glans. Ten percent had tumors on the prepuce (foreskin), and 25% had tumors in both areas.
Almost half the men underwent partial penis amputation and almost a quarter had their tumors excised. Other surgical approaches included circumcision, glansectomy, and total penectomy.
For roughly three-quarters of the men, treatment followed EAU guidelines (75% for surgery, 73% for lymphadenectomy). Among the rest, 17% of the men and 52% of the surgeons made the choice not to adhere to guidelines. For 31%, non-adherence had other causes.
The researchers found following EAU guidelines was associated with better overall survival. Medscape Medical News reported that “after adjustment for adherence to lymphadenectomy recommendations, age, tumor stage, the presence of palpable nodes, and tumor grade, overall survival was 54% better for patients treated in accordance with EAU recommendations than for those who were not.”
“Our data showed that the adherence to the EAU Guidelines on [penile cancer] should be reinforced, endorsed and encouraged in all the centers treating [penile cancer],” the authors wrote.
American Cancer Society
“Key Statistics for Penile Cancer”
(Last revised: January 4, 2018)
“What is Penile Cancer?”
(Last revised: February 9, 2016)
European Urology Supplements
Cindolo, L., et al.
“The adherence to the EAU Guidelines dramatically influences the survival of patients with penile cancer: Result from a retrospective international study (PECAD Study)”
(Abstract 24. Presented at 33rd Annual EAU Congress in Copenhagen, March 2018)
(Reviewed: August 15, 2016)
Medscape Medical News
“Penis Cancer Treatment Decisions Often Misguided”
(March 19, 2018)