Does the Identification of a Minimum Number of Cases Correlate With Better Adherence to International Guidelines Regarding the Treatment of Penile Cancer? Survey Results of the European PROspective Penile Cancer Study (E-PROPS)

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-515414 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.51541 Copy

Lebentrau, Steffen ; Wakileh, Gamal Anton ; Schostak, Martin ; Schmid, Hans-Peter ; Suarez-Ibarrola, Rodrigo ; Merseburger, Axel S. ; Hutterer, Georg C. ; Necknig, Ulrike H. ; Rink, Michael ; Bögemann, Martin ; Kluth, Luis Alex ; Pycha, Armin ; Burger, Maximilian ; Brookman-May, Sabine D. ; Bründl, Johannes ; May, Matthias

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Lizenz: Creative Commons Namensnennung 4.0 International PDF - Veröffentlichte Version (607kB)

Veröffentlichungsdatum dieses Volltextes: 31 Jan 2022 12:37

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Details

Dokumentenart:	Artikel
Open Access Art:	Gold (mit APC - bezahlt UR)
Titel eines Journals oder einer Zeitschrift:	Frontiers in Oncology
Verlag:	Frontiers
Ort der Veröffentlichung:	LAUSANNE
Band:	2021
Nummer des Zeitschriftenheftes oder des Kapitels:	11
Seitenbereich:	S. 1-8
Datum:	29 November 2021
Institutionen:	Medizin > Lehrstuhl für Urologie
Identifikationsnummer:	Wert Typ 10.3389/fonc.2021.759362 DOI
Stichwörter / Keywords:	MANAGEMENT; CHEMOTHERAPY; OUTCOMES; penile neoplasms; guideline adherence; organ-sparing treatment; lymph node dissection; chemotherapy
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Ja
Dokumenten-ID:	51541

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Zusammenfassung

BackgroundPenile cancer represents a rare malignant disease, whereby a small caseload is associated with the risk of inadequate treatment expertise. Thus, we hypothesized that strict guideline adherence might be considered a potential surrogate for treatment quality. This study investigated the influence of the annual hospital caseload on guideline adherence regarding treatment recommendations ...

Zusammenfassung

BackgroundPenile cancer represents a rare malignant disease, whereby a small caseload is associated with the risk of inadequate treatment expertise. Thus, we hypothesized that strict guideline adherence might be considered a potential surrogate for treatment quality. This study investigated the influence of the annual hospital caseload on guideline adherence regarding treatment recommendations for penile cancer. MethodsIn a 2018 survey study, 681 urologists from 45 hospitals in four European countries were queried about six hypothetical case scenarios (CS): local treatment of the primary tumor pTis (CS1) and pT1b (CS2); lymph node surgery inguinal (CS3) and pelvic (CS4); and chemotherapy neoadjuvant (CS5) and adjuvant (CS6). Only the responses from 206 head and senior physicians, as decision makers, were evaluated. The answers were assessed based on the applicable European Association of Urology (EAU) guidelines regarding their correctness. The real hospital caseload was analyzed based on multivariate logistic regression models regarding its effect on guideline adherence. ResultsThe median annual hospital caseload was 6 (interquartile range (IQR) 3-9). Recommendations for CS1-6 were correct in 79%, 66%, 39%, 27%, 28%, and 28%, respectively. The probability of a guideline-adherent recommendation increased with each patient treated per year in a clinic for CS1, CS2, CS3, and CS6 by 16%, 7.8%, 7.2%, and 9.5%, respectively (each p < 0.05); CS4 and CS5 were not influenced by caseload. A caseload threshold with a higher guideline adherence for all endpoints could not be perceived. The type of hospital care (academic vs. non-academic) did not affect guideline adherence in any scenario. ConclusionsGuideline adherence for most treatment recommendations increases with growing annual penile cancer caseload. Thus, the results of our study call for a stronger centralization of diagnosis and treatment strategies regarding penile cancer.

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