Evaluation of the Guidelines for Penile Cancer Treatment: Overview and Assessment

Abstract

Introduction: Medical organizations have provided evidence-based guidelines for penile cancer treatment. This current review aims to compare and appraise guidelines on penile cancer treatment to provide a useful summary for clinicians. make an evidence-based approach in the clinical practice. Materials and Methods: We searched in PubMed and Medline for guidelines published between January 1, 2010, and February 1, 2020. The search query terms were “penile cancer,” “penile tumor,” “guidelines,” and “penile malignancy.” In the final analysis, we include the most recent versions of relevant guidelines published in English. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to appraise the quality of each guideline. Results: In the final analysis, we included guidelines from the National Comprehensive Cancer Network (updated in 2020), The European Association of Urology (updated in 2018), and The European Society for Medical Oncology (published in 2013). The overall agreement among reviewers was excellent. The range of scores for each domain was as follows: scope and purpose (46% to 61%); stakeholder involvement (33% to 60%); rigor of development (34% to 69%); clarity and presentation (61% to 81%); applicability (33% to 59%) and editorial independence (52% to 78%). The European Association of Urology and National Comprehensive Cancer Network clinical practice guidelines received better scores according to the AGREE II evaluation. Conclusion: Despite the effort made by the guidelines groups to make a practical guideline regarding penile cancer treatment, the actual available evidence is weak. However, we believe our recommendations offer clear guidance.

Recent developments in the diagnosis and management of N1 penile cancer

“…Controversy exists regarding the pathological staging of pSCC lymphadenopathy (Table 2). However, for intermediate/high-risk primary tumours (p!T1G2), dynamic sentinel lymph node biopsy (DSNB) is supported by international guidelines as a reliable method to stage micrometastasis [11,12].…”