TY - JOUR
T1 - European Association of Urology-American Society of Clinical Oncology Collaborative Guideline on Penile Cancer
T2 - 2023 Update
AU - Brouwer, Oscar R
AU - Albersen, Maarten
AU - Parnham, Arie
AU - Protzel, Chris
AU - Pettaway, Curtis A
AU - Ayres, Benjamin
AU - Antunes-Lopes, Tiago
AU - Barreto, Lenka
AU - Campi, Riccardo
AU - Crook, Juanita
AU - Fernández-Pello, Sergio
AU - Greco, Isabella
AU - van der Heijden, Michiel S
AU - Johnstone, Peter A S
AU - Kailavasan, Mithun
AU - Manzie, Kenneth
AU - Marcus, Jack David
AU - Necchi, Andrea
AU - Oliveira, Pedro
AU - Osborne, John
AU - Pagliaro, Lance C
AU - Garcia-Perdomo, Herney A
AU - Rumble, R Bryan
AU - Sachdeva, Ashwin
AU - Sakalis, Vasileios I
AU - Zapala, Łukasz
AU - Sánchez Martínez, Diego F
AU - Spiess, Philippe E
AU - Tagawa, Scott T
N1 - Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2023/3/7
Y1 - 2023/3/7
N2 - CONTEXT: 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.OBJECTIVE: To provide a collaborative guideline that offers worldwide physician and patient guidance for the management of penile cancer.EVIDENCE ACQUISITION: 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.EVIDENCE SYNTHESIS: 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.CONCLUSIONS: 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.PATIENT SUMMARY: 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.
AB - CONTEXT: 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.OBJECTIVE: To provide a collaborative guideline that offers worldwide physician and patient guidance for the management of penile cancer.EVIDENCE ACQUISITION: 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.EVIDENCE SYNTHESIS: 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.CONCLUSIONS: 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.PATIENT SUMMARY: 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.
U2 - 10.1016/j.eururo.2023.02.027
DO - 10.1016/j.eururo.2023.02.027
M3 - Review article
C2 - 36906413
SN - 0302-2838
JO - European Urology
JF - European Urology
ER -
