INTRODUCTION: Although its incidence is increasing, penile cancer remains a rare disease in the UK. In view of this low volume, the National Institute for Clinical Excellence recommended that treatment is centralised in a limited number of centres arranged as supraregional networks. The aim of this centralisation is to allow the best standardised treatment for the primary tumours and nodal disease, thereby avoiding under or overtreatment. In this paper we review the formation and functioning of our network in the East Midlands. METHODS: Data were collected up to August 2010 from our prospective penile network database since its inception in 2005. These data were analysed to see our workload, patterns of referral and surgeries performed over this time period. RESULTS: The structure and function of the East Midlands network are described. There has been an increase in the number of cases discussed since its formation. There has also been a trend towards more conservative surgery, both of the primary tumour and of nodal management. Between September 2009 and August 2010, 16 glansectomies were performed versus 5 total and 9 partial penectomies. The same period saw 18 dynamic sentinel lymph node biopsies against 7 bilateral and 3 unilateral superficial groin dissections. There was a very high patient satisfaction rate, with patients feeling they had good support and information. CONCLUSIONS: On reviewing the literature it can be clearly seen that supraregional networks have led to a decrease in overtreatment and better recognition of the need to manage lymph node status optimally. Our network has demonstrated the trend toward conservative surgery and sentinel node biopsy. The formation of supraregional networks with a multidisciplinary approach will facilitate high volume centres that will offer optimal surgical therapy and also allow recruitment into studies and new chemotherapeutic regimens. It will also allow better data collection to aid clinical studies that hopefully will also demonstrate better outcomes.
INTRODUCTION: Although its incidence is increasing, penile cancer remains a rare disease in the UK. In view of this low volume, the National Institute for Clinical Excellence recommended that treatment is centralised in a limited number of centres arranged as supraregional networks. The aim of this centralisation is to allow the best standardised treatment for the primary tumours and nodal disease, thereby avoiding under or overtreatment. In this paper we review the formation and functioning of our network in the East Midlands. METHODS: Data were collected up to August 2010 from our prospective penile network database since its inception in 2005. These data were analysed to see our workload, patterns of referral and surgeries performed over this time period. RESULTS: The structure and function of the East Midlands network are described. There has been an increase in the number of cases discussed since its formation. There has also been a trend towards more conservative surgery, both of the primary tumour and of nodal management. Between September 2009 and August 2010, 16 glansectomies were performed versus 5 total and 9 partial penectomies. The same period saw 18 dynamic sentinel lymph node biopsies against 7 bilateral and 3 unilateral superficial groin dissections. There was a very high patient satisfaction rate, with patients feeling they had good support and information. CONCLUSIONS: On reviewing the literature it can be clearly seen that supraregional networks have led to a decrease in overtreatment and better recognition of the need to manage lymph node status optimally. Our network has demonstrated the trend toward conservative surgery and sentinel node biopsy. The formation of supraregional networks with a multidisciplinary approach will facilitate high volume centres that will offer optimal surgical therapy and also allow recruitment into studies and new chemotherapeutic regimens. It will also allow better data collection to aid clinical studies that hopefully will also demonstrate better outcomes.
Authors: Giorgio Pizzocaro; Ferran Algaba; Simon Horenblas; Eduard Solsona; Silvia Tana; Hein Van Der Poel; Nicholas A Watkin Journal: Eur Urol Date: 2010-02-04 Impact factor: 20.096
Authors: Frederico Ramalho Romero; Karen Richter Pereira dos Santos Romero; Marcus Augusto Elias de Mattos; Carlos Ricardo Camargo Garcia; Roni de Carvalho Fernandes; Marjo Deninson Cardenuto Perez Journal: Urology Date: 2005-12 Impact factor: 2.649
Authors: Carlos E Stecca; Marie Alt; Di Maria Jiang; Peter Chung; Juanita M Crook; Girish S Kulkarni; Srikala S Sridhar Journal: Oncol Ther Date: 2021-01-16
Authors: Marco Bandini; Mohamed Ahmed; Giuseppe Basile; Nicholas Watkin; Viraj Master; Yao Zhu; Gagan Prakash; Alejandro Rodriguez; Mbaaga K Ssebakumba; Riccardo Leni; Giuseppe Ottone Cirulli; Ben Ayres; Rachel Compitello; Filippo Pederzoli; Pankaj M Joshi; Sanjay B Kulkarni; Francesco Montorsi; Guru Sonpavde; Andrea Necchi; Philippe E Spiess Journal: Nat Rev Urol Date: 2021-12-22 Impact factor: 16.430