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)

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 infl...

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Autores principales:	Steffen Lebentrau, Gamal Anton Wakileh, Martin Schostak, Hans-Peter Schmid, Rodrigo Suarez-Ibarrola, Axel S. Merseburger, Georg C. Hutterer, Ulrike H. Necknig, Michael Rink, Martin Bögemann, Luis Alex Kluth, Armin Pycha, Maximilian Burger, Sabine D. Brookman-May, Johannes Bründl, Matthias May
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	penile neoplasms guideline adherence organ-sparing treatment lymph node dissection chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c1376d782de048189d86ed4a5b3c2f01
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spelling	oai:doaj.org-article:c1376d782de048189d86ed4a5b3c2f012021-12-01T13:58:13ZDoes 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)2234-943X10.3389/fonc.2021.759362https://doaj.org/article/c1376d782de048189d86ed4a5b3c2f012021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.759362/fullhttps://doaj.org/toc/2234-943XBackgroundPenile 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.Steffen LebentrauGamal Anton WakilehMartin SchostakHans-Peter SchmidRodrigo Suarez-IbarrolaAxel S. MerseburgerGeorg C. HuttererUlrike H. NecknigMichael RinkMartin BögemannLuis Alex KluthArmin PychaArmin PychaMaximilian BurgerSabine D. Brookman-MayJohannes BründlMatthias MayMatthias MayFrontiers Media S.A.articlepenile neoplasmsguideline adherenceorgan-sparing treatmentlymph node dissectionchemotherapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	penile neoplasms guideline adherence organ-sparing treatment lymph node dissection chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	penile neoplasms guideline adherence organ-sparing treatment lymph node dissection chemotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Steffen Lebentrau Gamal Anton Wakileh Martin Schostak Hans-Peter Schmid Rodrigo Suarez-Ibarrola Axel S. Merseburger Georg C. Hutterer Ulrike H. Necknig Michael Rink Martin Bögemann Luis Alex Kluth Armin Pycha Armin Pycha Maximilian Burger Sabine D. Brookman-May Johannes Bründl Matthias May Matthias May 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)
description	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.
format	article
author	Steffen Lebentrau Gamal Anton Wakileh Martin Schostak Hans-Peter Schmid Rodrigo Suarez-Ibarrola Axel S. Merseburger Georg C. Hutterer Ulrike H. Necknig Michael Rink Martin Bögemann Luis Alex Kluth Armin Pycha Armin Pycha Maximilian Burger Sabine D. Brookman-May Johannes Bründl Matthias May Matthias May
author_facet	Steffen Lebentrau Gamal Anton Wakileh Martin Schostak Hans-Peter Schmid Rodrigo Suarez-Ibarrola Axel S. Merseburger Georg C. Hutterer Ulrike H. Necknig Michael Rink Martin Bögemann Luis Alex Kluth Armin Pycha Armin Pycha Maximilian Burger Sabine D. Brookman-May Johannes Bründl Matthias May Matthias May
author_sort	Steffen Lebentrau
title	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)
title_short	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)
title_full	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)
title_fullStr	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)
title_full_unstemmed	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)
title_sort	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)
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/c1376d782de048189d86ed4a5b3c2f01
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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)

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