Volume outcome relationship in penile cancer: a systematic review.

Overview

PURPOSE OF REVIEW: Penile cancer is a rare disease with significant morbidity. Because of the low volume of cases, it has been suggested that its treatment should be centralized in order to improve outcomes through better management of both the primary tumor and distant disease. We reviewed and summarized the most relevant recent publications regarding centralization of penile cancer management. RECENT FINDINGS: Management of penile cancer in academic and supra-regional centers was associated with better survival outcomes. Moreover, reports from population-based studies showed more adherence to guidelines recommendations in academic centers with higher utilization of organ sparing treatments and invasive inguinal lymph node staging. SUMMARY: The optimal management of penile cancer remains a major therapeutic challenge. Patients with invasive tumors are less adequately managed in lower volume nonspecialized centers. The data convincingly support efforts to centralize penile cancer care and to promote the development of centers of expertise in order to achieve the best possible outcomes for each patient.