EAU guidelines on penile cancer: 2014 update

Oliver W. Hakenberg, Eva M. Compérat, Suks Minhas, Andrea Necchi, Chris Protzel, Nick Watkin

Research output: Contribution to journalArticle

216 Citations (Scopus)

Abstract

Context Penile cancer has high mortality once metastatic spread has occurred. Local treatment can be mutilating and devastating for the patient. Progress has been made in organ-preserving local treatment, lymph node management, and multimodal treatment of lymphatic metastases, requiring an update of the European Association of Urology guidelines. Objective To provide an evidence-based update of treatment recommendations based on the literature published since 2008. Evidence acquisition A PubMed search covering the period from August 2008 to November 2013 was performed, and 352 full-text papers were reviewed. Levels of evidence were assessed and recommendations graded. Because there is a lack of controlled trials or large series, the levels of evidence and grades of recommendation are low compared with those for more common diseases. Evidence synthesis Penile squamous cell carcinoma occurs in distinct histologic variants, some of which are related to human papilloma virus infection; others are not. Primary local treatment should be organ preserving, if possible. There are no outcome differences between local treatment modes in superficial and T1 disease. Management of inguinal lymph nodes is crucial for prognosis. In impalpable nodes, invasive staging should be done depending on the risk factors of the primary tumour. Lymph node metastases should be treated by surgery and adjuvant chemotherapy in N2/N3 disease. Conclusions Organ preservation has become the standard approach to low-stage penile cancer, whereas in lymphatic disease, it is recognised that multimodal treatment with radical inguinal node surgery and adjuvant chemotherapy improves outcome. Patient summary Approximately 80% of penile cancer patients of all stages can be cured. With increasing experience in the management of penile cancer, it is recognized that organ-preserving treatment allows for better quality of life and sexual function and should be offered to all patients whenever feasible. Referral to centres with experience is recommended.

Original languageEnglish
Pages (from-to)142-150
Number of pages9
JournalEuropean Urology
Volume67
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Penile Neoplasms
Guidelines
Combined Modality Therapy
Groin
Lymph Nodes
Adjuvant Chemotherapy
Papillomaviridae
Therapeutics
Organ Preservation
Lymphatic Metastasis
Lymphatic Diseases
Virus Diseases
PubMed
Squamous Cell Carcinoma
Referral and Consultation
Quality of Life
Neoplasm Metastasis
Mortality

Keywords

  • Association of Urology
  • Chemotherapy
  • European
  • Follow-up
  • Guidelines
  • Invasive disease
  • Laser
  • Lymph node
  • Metastasis
  • Penile cancer
  • Quality of life
  • Reconstruction
  • Squamous cell carcinoma
  • Surgery

ASJC Scopus subject areas

  • Urology

Cite this

Hakenberg, O. W., Compérat, E. M., Minhas, S., Necchi, A., Protzel, C., & Watkin, N. (2015). EAU guidelines on penile cancer: 2014 update. European Urology, 67(1), 142-150. https://doi.org/10.1016/j.eururo.2014.10.017

EAU guidelines on penile cancer : 2014 update. / Hakenberg, Oliver W.; Compérat, Eva M.; Minhas, Suks; Necchi, Andrea; Protzel, Chris; Watkin, Nick.

In: European Urology, Vol. 67, No. 1, 01.01.2015, p. 142-150.

Research output: Contribution to journalArticle

Hakenberg, OW, Compérat, EM, Minhas, S, Necchi, A, Protzel, C & Watkin, N 2015, 'EAU guidelines on penile cancer: 2014 update', European Urology, vol. 67, no. 1, pp. 142-150. https://doi.org/10.1016/j.eururo.2014.10.017
Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N. EAU guidelines on penile cancer: 2014 update. European Urology. 2015 Jan 1;67(1):142-150. https://doi.org/10.1016/j.eururo.2014.10.017
Hakenberg, Oliver W. ; Compérat, Eva M. ; Minhas, Suks ; Necchi, Andrea ; Protzel, Chris ; Watkin, Nick. / EAU guidelines on penile cancer : 2014 update. In: European Urology. 2015 ; Vol. 67, No. 1. pp. 142-150.
@article{9479de3355b0471d9239a78e665ed7c7,
title = "EAU guidelines on penile cancer: 2014 update",
abstract = "Context Penile cancer has high mortality once metastatic spread has occurred. Local treatment can be mutilating and devastating for the patient. Progress has been made in organ-preserving local treatment, lymph node management, and multimodal treatment of lymphatic metastases, requiring an update of the European Association of Urology guidelines. Objective To provide an evidence-based update of treatment recommendations based on the literature published since 2008. Evidence acquisition A PubMed search covering the period from August 2008 to November 2013 was performed, and 352 full-text papers were reviewed. Levels of evidence were assessed and recommendations graded. Because there is a lack of controlled trials or large series, the levels of evidence and grades of recommendation are low compared with those for more common diseases. Evidence synthesis Penile squamous cell carcinoma occurs in distinct histologic variants, some of which are related to human papilloma virus infection; others are not. Primary local treatment should be organ preserving, if possible. There are no outcome differences between local treatment modes in superficial and T1 disease. Management of inguinal lymph nodes is crucial for prognosis. In impalpable nodes, invasive staging should be done depending on the risk factors of the primary tumour. Lymph node metastases should be treated by surgery and adjuvant chemotherapy in N2/N3 disease. Conclusions Organ preservation has become the standard approach to low-stage penile cancer, whereas in lymphatic disease, it is recognised that multimodal treatment with radical inguinal node surgery and adjuvant chemotherapy improves outcome. Patient summary Approximately 80{\%} of penile cancer patients of all stages can be cured. With increasing experience in the management of penile cancer, it is recognized that organ-preserving treatment allows for better quality of life and sexual function and should be offered to all patients whenever feasible. Referral to centres with experience is recommended.",
keywords = "Association of Urology, Chemotherapy, European, Follow-up, Guidelines, Invasive disease, Laser, Lymph node, Metastasis, Penile cancer, Quality of life, Reconstruction, Squamous cell carcinoma, Surgery",
author = "Hakenberg, {Oliver W.} and Comp{\'e}rat, {Eva M.} and Suks Minhas and Andrea Necchi and Chris Protzel and Nick Watkin",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.eururo.2014.10.017",
language = "English",
volume = "67",
pages = "142--150",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier B.V.",
number = "1",

}

TY - JOUR

T1 - EAU guidelines on penile cancer

T2 - 2014 update

AU - Hakenberg, Oliver W.

AU - Compérat, Eva M.

AU - Minhas, Suks

AU - Necchi, Andrea

AU - Protzel, Chris

AU - Watkin, Nick

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Context Penile cancer has high mortality once metastatic spread has occurred. Local treatment can be mutilating and devastating for the patient. Progress has been made in organ-preserving local treatment, lymph node management, and multimodal treatment of lymphatic metastases, requiring an update of the European Association of Urology guidelines. Objective To provide an evidence-based update of treatment recommendations based on the literature published since 2008. Evidence acquisition A PubMed search covering the period from August 2008 to November 2013 was performed, and 352 full-text papers were reviewed. Levels of evidence were assessed and recommendations graded. Because there is a lack of controlled trials or large series, the levels of evidence and grades of recommendation are low compared with those for more common diseases. Evidence synthesis Penile squamous cell carcinoma occurs in distinct histologic variants, some of which are related to human papilloma virus infection; others are not. Primary local treatment should be organ preserving, if possible. There are no outcome differences between local treatment modes in superficial and T1 disease. Management of inguinal lymph nodes is crucial for prognosis. In impalpable nodes, invasive staging should be done depending on the risk factors of the primary tumour. Lymph node metastases should be treated by surgery and adjuvant chemotherapy in N2/N3 disease. Conclusions Organ preservation has become the standard approach to low-stage penile cancer, whereas in lymphatic disease, it is recognised that multimodal treatment with radical inguinal node surgery and adjuvant chemotherapy improves outcome. Patient summary Approximately 80% of penile cancer patients of all stages can be cured. With increasing experience in the management of penile cancer, it is recognized that organ-preserving treatment allows for better quality of life and sexual function and should be offered to all patients whenever feasible. Referral to centres with experience is recommended.

AB - Context Penile cancer has high mortality once metastatic spread has occurred. Local treatment can be mutilating and devastating for the patient. Progress has been made in organ-preserving local treatment, lymph node management, and multimodal treatment of lymphatic metastases, requiring an update of the European Association of Urology guidelines. Objective To provide an evidence-based update of treatment recommendations based on the literature published since 2008. Evidence acquisition A PubMed search covering the period from August 2008 to November 2013 was performed, and 352 full-text papers were reviewed. Levels of evidence were assessed and recommendations graded. Because there is a lack of controlled trials or large series, the levels of evidence and grades of recommendation are low compared with those for more common diseases. Evidence synthesis Penile squamous cell carcinoma occurs in distinct histologic variants, some of which are related to human papilloma virus infection; others are not. Primary local treatment should be organ preserving, if possible. There are no outcome differences between local treatment modes in superficial and T1 disease. Management of inguinal lymph nodes is crucial for prognosis. In impalpable nodes, invasive staging should be done depending on the risk factors of the primary tumour. Lymph node metastases should be treated by surgery and adjuvant chemotherapy in N2/N3 disease. Conclusions Organ preservation has become the standard approach to low-stage penile cancer, whereas in lymphatic disease, it is recognised that multimodal treatment with radical inguinal node surgery and adjuvant chemotherapy improves outcome. Patient summary Approximately 80% of penile cancer patients of all stages can be cured. With increasing experience in the management of penile cancer, it is recognized that organ-preserving treatment allows for better quality of life and sexual function and should be offered to all patients whenever feasible. Referral to centres with experience is recommended.

KW - Association of Urology

KW - Chemotherapy

KW - European

KW - Follow-up

KW - Guidelines

KW - Invasive disease

KW - Laser

KW - Lymph node

KW - Metastasis

KW - Penile cancer

KW - Quality of life

KW - Reconstruction

KW - Squamous cell carcinoma

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=84964238212&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84964238212&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2014.10.017

DO - 10.1016/j.eururo.2014.10.017

M3 - Article

C2 - 25457021

AN - SCOPUS:84964238212

VL - 67

SP - 142

EP - 150

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 1

ER -