阴茎癌（PeCa）由于患者数量较少，给诊断和治疗带来了挑战，可能导致医生专业知识不足和遵循指南不力。自2015年以来，我们在我们的三级转诊中心针对PeCa制定了专门的护理路径。为了评估专门的PeCa护理路径对患者管理、病理报告的适度性和肿瘤学结果的影响，我们在2022年4月之前对我们的机构登记处（S-66482）进行了回顾性查询，以确定自1989年1月至2022年4月期间接受手术治疗的PeCa患者。患者数量在广义的国家背景下进行评估。我们比较了2015年之前和之后的患者、手术、肿瘤和病理数据。使用Kaplan-Meier分析比较了局部和区域复发率以及癌症特异性生存（CSS）。总体上，共纳入了313名患者，其中204名（65.1%）在2015年之后接受了手术治疗。在2015年之后，每年接受治疗的患者数显著增加（26 vs 5；p < 0.01）。尽管原发肿瘤分期相似，但在2015年之后，诊断时无触摸到淋巴结的患者更为常见。在采用PeCa护理路径后，器官保留手术（OSS）更常见（79.9% vs 57.8%；p < 0.01），尽管局部分期类似且未观察到阳性切缘的显著增加。在欧洲泌尿学协会中患有中度或高风险肿瘤的患者中，2015年之后更频繁地进行了手术分期（90% vs 41%；p < 0.01）。病理学报告达到了标准化，并更频繁地报告了p16染色状态（81.4% vs 8.3%；p < 0.01）、淋巴管侵犯（93.8% vs 44.3%；p < 0.01）和神经外膜侵犯（92.4% vs 44.3%；p < 0.01）。实施标准化的PeCa护理路径导致了更高的OSS和病理淋巴结分期率以及更完整的病理学报告。考虑到这些变化与接受治疗的患者数量的增加相关，以学术驱动的集中化可能在优化这些患者的管理方面发挥作用。我们评估了关于阴茎癌患者护理路径对患者管理、病理学报告的完整性以及癌症控制的影响。我们发现实施该护理路径与接受治疗的患者数量的增加、更高的器官保留手术和淋巴结分期率以及更完整的病理学报告相关。护理的集中化可以在优化阴茎癌的管理中起到作用。版权所有© 2023年欧洲泌尿学会。由Elsevier B.V.发表。保留所有权利。

Penile cancer (PeCa) represents a diagnostic and therapeutic challenge given the low patient volume, which may result in inadequate physician expertise and poor guideline adherence. Since 2015, we have developed a specific care pathway for PeCa in our tertiary referral center.To evaluate the impact of a dedicated PeCa care pathway on patient management, the adequacy of pathological reporting, and oncological outcomes.We retrospectively queried our institutional registry (S-66482) to identify patients who were surgically treated for PeCa between January 1989 and April 2022. The patient numbers were evaluated within a broader national context.We compared patient, surgery, tumor, and pathological data before and after 2015. Kaplan-Meier analysis was used to compare local and regional recurrence rates and cancer-specific survival (CSS).Overall, 313 patients were included, of whom 204 (65.1%) were surgically treated after 2015. The median number of patients treated yearly was significantly higher after 2015 (26 vs 5; p < 0.01). Patients treated after 2015 more frequently had no palpable lymph nodes at diagnosis, despite similar primary tumor stage. After adoption of the PeCa care pathway, organ-sparing surgery (OSS) was more commonly performed (79.9% vs 57.8%; p < 0.01) despite local staging being similar and without observing a significant increase in positive margins. Surgical staging in patients with European Association of Urology intermediate- or high-risk tumors was conducted more frequently after 2015 (90% vs 41%; p < 0.01). Pathology reporting was standardized, and there was more frequent reporting of p16 staining status (81.4% vs 8.3%; p < 0.01), lymphovascular invasion (93.8% vs 44.3%; p < 0.01), and perineural invasion (92.4% vs 44.3%; p < 0.01) following implementation.Implementation of a standardized care pathway for PeCa resulted in higher rates of OSS and pathological nodal staging and more complete pathology reports. Considering that these changes were associated with an increase in the number of patients treated, academic-driven centralization may play a role in optimizing the management of these patients.We evaluated the impact of a care pathway for patients with penile cancer on patient management, the completeness of pathology reporting, and cancer control. We found that implementation of this pathway was associated with an increase in the number of patients treated, higher rates of organ-sparing surgery and lymph node staging, and more complete pathology reports. Centralization of care may play a role in optimizing the management of penile cancer.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.