A Thomas1, F Kölling2, A Haferkamp2, I Tsaur2. 1. Klinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland. anita.thomas@unimedizin-mainz.de. 2. Klinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
Abstract
BACKGROUND: Penile cancer is a rare malignancy and the wide range of quality of care associated with it often results in inferior oncologic and functional treatment outcomes. OBJECTIVES: Assessment of the current healthcare situation in clinical routine and identification of the relevant key features and reference values for quality of care. MATERIALS AND METHODS: Search for relevant peer-reviewed articles and published congress abstracts in Medline, Embase and other databases as well as Google web search engine. RESULTS: Key quality features of penile cancer management include organ-sparing surgery of the primary tumor, invasive inguinal lymph node staging and systemic treatment. Adherence to treatment guidelines is currently low. Centralization of care has already led to a considerable improvement in the quality of care in some areas and increasing conformity with the guidelines' recommendations. CONCLUSION: Centralization of care and networks based on this can significantly improve patient outcomes. Thus, reference values for core parameters of quality cancer care can be generated and validated. Moreover, organ-sparing surgery, invasive lymph node staging and systemic therapy should be increasingly utilized. As a reference value, 90% adherence to the guidelines for these three features is recommended. However, before centralization of care can be introduced, aspects relevant to practical implementation must be addressed, such as the reimbursement of travel costs for those affected, infrastructure costs and instruments to measure quality of life and patient satisfaction after centralization.
BACKGROUND: Penile cancer is a rare malignancy and the wide range of quality of care associated with it often results in inferior oncologic and functional treatment outcomes. OBJECTIVES: Assessment of the current healthcare situation in clinical routine and identification of the relevant key features and reference values for quality of care. MATERIALS AND METHODS: Search for relevant peer-reviewed articles and published congress abstracts in Medline, Embase and other databases as well as Google web search engine. RESULTS: Key quality features of penile cancer management include organ-sparing surgery of the primary tumor, invasive inguinal lymph node staging and systemic treatment. Adherence to treatment guidelines is currently low. Centralization of care has already led to a considerable improvement in the quality of care in some areas and increasing conformity with the guidelines' recommendations. CONCLUSION: Centralization of care and networks based on this can significantly improve patient outcomes. Thus, reference values for core parameters of quality cancer care can be generated and validated. Moreover, organ-sparing surgery, invasive lymph node staging and systemic therapy should be increasingly utilized. As a reference value, 90% adherence to the guidelines for these three features is recommended. However, before centralization of care can be introduced, aspects relevant to practical implementation must be addressed, such as the reimbursement of travel costs for those affected, infrastructure costs and instruments to measure quality of life and patient satisfaction after centralization.
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