- Email: [email protected]
The adherence to the EAU Guidelines on penile cancer treatment could influence the survival: Multicenter, retrospective study
32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom
706
The adherence to the EAU Guidelines on penile cancer treatment could influence the survival: Multicenter, retrospective study Eur Urol Suppl 2017; 16(3);e1222
Cindolo L.1, Bada M.1, Nyirády P.2, Varga J.2, Ditonno P.3, Boccasile S.3, Battaglia M.3, Chiodini P.4, Berardinelli F.1, De Nunzio C.5, Tema G.5, Veccia A.6, Antonelli A.6, Simeone C.6, Puliatti S.7, Micali S.7, Schips L.1 1
ASL Abruzzo 2, Dept. of Urology, Chieti, Italy, 2Budapest Hospital, Dept. of Urology, Budapest, Hungary, 3University of Bari, Dept. of Emergency and Organ Transplantation, Bari, Italy, 4Second University of Naples, Medical Statistics Unit, Naples, Italy, 5S. Andrea Hospital, Dept. of Urology, Rome, Italy, 6Spedali Civili, Dept. of Urology, Brescia, Italy, 7University of Modena and Reggio Emilia, Dept. of Urology, Baggiovara, Italy INTRODUCTION & OBJECTIVES: Penile Cancer (PC) is uncommon in Western countries with an incidence of ≤1.0/100.000 males, aged 50-70 years. Circumcision in childhood is protective. Due to its low incidence and low volume of surgical series it is difficult to achieve good quality guidelines with robust recommendations. Aims of this study were 1) to evaluate the adherence to the EAU guidelines on PC in terms of primary treatment and lymphadenectomy; 2) to weight the impact of the adherence on survival outcomes. MATERIAL & METHODS: We retrospectively reviewed the clinical charts of 176 patients underwent penile surgery for neoplasms in 8 European Centres(2010-2016). Demographics, patient’s comorbidity, circumcision, site of primary lesion, perioperative and histopathological data were collected and analysed. The follow-up was updated by recall of all patients. For each case the theoretical adherence to 2016 EAU Guidelines for the primary surgery and the lymphoadenectomy were evaluated. A comparison between theoretical and practical surgical approach was done in order to evaluate the adherence rate. The TNM 2009 was used to classify stage and grade.Descriptive, univariate and multivariate analyses were performed to evaluate the impact of the adherence on survival. Kaplan-Meier curves were estimated. RESULTS: 176 patients were enrolled (median age 66.5 y +/- 11.3). 56.5% was uncircumcised. The lesions were located at the glans, the prepuce and on both sites in 55%, 11% and 34%, respectively. The surgical approaches adopted were radical circumcision, tumor excision, glansectomy, penile partial amputation, total emasculation in 7%, 24%, 15%, 39%, 15%, respectively. All PC were squamous carcinoma. The staging was 16%
Eur Urol Suppl 2017; 16(3);e1222
32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom
706
The adherence to the EAU Guidelines on penile cancer treatment could influence the survival: Multicenter, retrospective study Eur Urol Suppl 2017; 16(3);e1223
adherence to the EAU Guidelines on Primary Surgery, after adjustments for age, TNM stage and LY significantly influences the overall survival (HR 0.42 (95% CI 0.23-0.79, p=0.007)). Moreover the adherence to the EAU Guidelines for LY, after adjustments for age, TNM stage, Palpable Nodes and Grade, significantly influences the overall survival (HR 0.30 (95% CI 0.16-0.58, p<0.001)). The adherence to EAU Guidelines showed a trend of statistical significance on Progression Free Survival. CONCLUSIONS: Our data showed that the adherence to the EAU Guidelines on PC: is quite optimal across 8 European Centers; strongly influences the survival outcomes; should be reinforced, endorsed and encouraged in all the centers treating PC.
Eur Urol Suppl 2017; 16(3);e1223 Powered by TCPDF (www.tcpdf.org)
706
The adherence to the EAU Guidelines on penile cancer treatment could influence the survival: Multicenter, retrospective study Eur Urol Suppl 2017; 16(3);e1222
Cindolo L.1, Bada M.1, Nyirády P.2, Varga J.2, Ditonno P.3, Boccasile S.3, Battaglia M.3, Chiodini P.4, Berardinelli F.1, De Nunzio C.5, Tema G.5, Veccia A.6, Antonelli A.6, Simeone C.6, Puliatti S.7, Micali S.7, Schips L.1 1
ASL Abruzzo 2, Dept. of Urology, Chieti, Italy, 2Budapest Hospital, Dept. of Urology, Budapest, Hungary, 3University of Bari, Dept. of Emergency and Organ Transplantation, Bari, Italy, 4Second University of Naples, Medical Statistics Unit, Naples, Italy, 5S. Andrea Hospital, Dept. of Urology, Rome, Italy, 6Spedali Civili, Dept. of Urology, Brescia, Italy, 7University of Modena and Reggio Emilia, Dept. of Urology, Baggiovara, Italy INTRODUCTION & OBJECTIVES: Penile Cancer (PC) is uncommon in Western countries with an incidence of ≤1.0/100.000 males, aged 50-70 years. Circumcision in childhood is protective. Due to its low incidence and low volume of surgical series it is difficult to achieve good quality guidelines with robust recommendations. Aims of this study were 1) to evaluate the adherence to the EAU guidelines on PC in terms of primary treatment and lymphadenectomy; 2) to weight the impact of the adherence on survival outcomes. MATERIAL & METHODS: We retrospectively reviewed the clinical charts of 176 patients underwent penile surgery for neoplasms in 8 European Centres(2010-2016). Demographics, patient’s comorbidity, circumcision, site of primary lesion, perioperative and histopathological data were collected and analysed. The follow-up was updated by recall of all patients. For each case the theoretical adherence to 2016 EAU Guidelines for the primary surgery and the lymphoadenectomy were evaluated. A comparison between theoretical and practical surgical approach was done in order to evaluate the adherence rate. The TNM 2009 was used to classify stage and grade.Descriptive, univariate and multivariate analyses were performed to evaluate the impact of the adherence on survival. Kaplan-Meier curves were estimated. RESULTS: 176 patients were enrolled (median age 66.5 y +/- 11.3). 56.5% was uncircumcised. The lesions were located at the glans, the prepuce and on both sites in 55%, 11% and 34%, respectively. The surgical approaches adopted were radical circumcision, tumor excision, glansectomy, penile partial amputation, total emasculation in 7%, 24%, 15%, 39%, 15%, respectively. All PC were squamous carcinoma. The staging was 16%
Eur Urol Suppl 2017; 16(3);e1222
32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom
706
The adherence to the EAU Guidelines on penile cancer treatment could influence the survival: Multicenter, retrospective study Eur Urol Suppl 2017; 16(3);e1223
adherence to the EAU Guidelines on Primary Surgery, after adjustments for age, TNM stage and LY significantly influences the overall survival (HR 0.42 (95% CI 0.23-0.79, p=0.007)). Moreover the adherence to the EAU Guidelines for LY, after adjustments for age, TNM stage, Palpable Nodes and Grade, significantly influences the overall survival (HR 0.30 (95% CI 0.16-0.58, p<0.001)). The adherence to EAU Guidelines showed a trend of statistical significance on Progression Free Survival. CONCLUSIONS: Our data showed that the adherence to the EAU Guidelines on PC: is quite optimal across 8 European Centers; strongly influences the survival outcomes; should be reinforced, endorsed and encouraged in all the centers treating PC.
Eur Urol Suppl 2017; 16(3);e1223 Powered by TCPDF (www.tcpdf.org)