{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:46:03Z","timestamp":1764603963409,"version":"3.37.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>\n      Zusammenfassung\n    <\/jats:title><jats:p>\n            Hintergrund Pro Jahr erkranken derzeit in Deutschland 959, in \u00d6sterreich 67 M\u00e4nner an einem Peniskarzinom, wobei es in der letzten Dekade zu einer Zunahme um etwa 20% kam [RKI 2021, Statcube.at 2023]. Trotz steigender Inzidenz bleiben die Fallzahlen je Klinik auf einem niedrigen Niveau. Die mediane j\u00e4hrliche Peniskarzinomfallzahl an Uniklinika der DACH-Region lag 2017 bei 7 Patienten (IQR 5\u201310) [E-PROPS-Gruppe 2021]. Die durch geringe Fallzahlen zwangsl\u00e4ufig kompromittierte institutionelle Expertise wird durch eine in mehreren Studien belegte unzureichende Adh\u00e4renz an Peniskarzinom-Leitlinien potenziert. Die z.B. in Gro\u00dfbritannien stringent umgesetzte Zentralisierung erm\u00f6glichte eine jeweils signifikante Zunahme organerhaltender Prim\u00e4rtumoroperationen und stadienadaptierter Lymphadenektomien sowie ein verbessertes \u00dcberleben der Patienten mit Peniskarzinom, sodass zunehmend auch in Deutschland und \u00d6sterreich eine Zentralisierung gefordert wird. Ziel der hier vorliegenden Studie war eine aktuelle Erfassung fallzahlabh\u00e4ngiger Effekte auf peniskarzinombezogene Behandlungsangebote an Uniklinika in Deutschland und \u00d6sterreich.\n    <\/jats:p><jats:p>\n            Material und Methoden Ein Fragebogen u.a. zu Fallzahlen f\u00fcr 2021 (station\u00e4r gesamt und Peniskarzinom), Behandlungsangeboten f\u00fcr Prim\u00e4rtumor und inguinale Lymphadenektomie (ILAE), zum Vorhalten einer Peniskarzinom-Hauptoperateur*in sowie zur fachlichen Verantwortung f\u00fcr die systemischen Therapien bei Peniskarzinom wurde im Januar 2023 an die Leitung von 48 urologischen Uniklinika in Deutschland und \u00d6sterreich versandt. Fallzahlbezogene Zusammenh\u00e4nge bzw. Unterschiede wurden unadjustiert statistisch gepr\u00fcft.\n    <\/jats:p><jats:p>\n            Ergebnisse Die R\u00fccklaufquote betrug 75% (n=36\/48). Insgesamt wurden 2021 an den 36 antwortenden Uniklinika 626 Peniskarzinompatienten behandelt, entsprechend etwa 60% der in Deutschland und \u00d6sterreich zu erwartenden Inzidenz. Die j\u00e4hrliche mediane Gesamtfallzahl lag bei 2807 (IQR 1937\u20133653), f\u00fcr das Peniskarzinom bei 13 (IQR 9\u201326). Es bestand keine signifikante Korrelation zwischen der station\u00e4ren Gesamt- und der Peniskarzinomfallzahl (p=0,34). Die Anzahl der organerhaltenden Therapieverfahren f\u00fcr den Primarius, das Angebot moderner ILAE-Verfahren, das Vorhalten einer Hauptoperateur*in f\u00fcr das Peniskarzinom und die Verantwortung f\u00fcr die Durchf\u00fchrung der systemischen Therapien wurden weder durch die station\u00e4re Gesamtfallzahl noch die Peniskarzinomfallzahl der behandelnden Kliniken signifikant beeinflusst \u2013 und zwar sowohl bei Dichotomisierung der Fallzahlen am Median als auch am oberen Quartil. Unterschiede zwischen Deutschland und \u00d6sterreich konnten nicht gezeigt werden.\n    <\/jats:p><jats:p>\n            Schlussfolgerung Trotz einer deutlichen Zunahme der j\u00e4hrlichen Peniskarzinomfallzahl an Universit\u00e4tskliniken in Deutschland und \u00d6sterreich gegen\u00fcber den Daten von 2017 konnten wir keine fallzahlabh\u00e4ngigen Effekte auf die Strukturqualit\u00e4t hinsichtlich der Therapie des Peniskarzinoms feststellen. Wir werten dieses Ergebnis vor dem Hintergrund der erwiesenen Vorteile einer Zentralisierung als Argument f\u00fcr die Notwendigkeit der Etablierung \u00fcberregional organisierter Peniskarzinomzentren mit im Vergleich zum Status quo nochmals deutlich h\u00f6heren Fallzahlen.\n    <\/jats:p>","DOI":"10.1055\/a-2090-5199","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T22:48:57Z","timestamp":1687301337000},"page":"285-291","source":"Crossref","is-referenced-by-count":2,"title":["Gibt es fallzahlabh\u00e4ngige Effekte auf Behandlungsangebote f\u00fcr Patienten mit einem Peniskarzinom? Ergebnisse einer Umfrage an Universit\u00e4tsklinika in Deutschland und \u00d6sterreich"],"prefix":"10.1055","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8782-3875","authenticated-orcid":false,"given":"Steffen","family":"Lebentrau","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Uroonkologie, robotergest\u00fctzte und fokale Therapie, Universit\u00e4tsklinikum Magdeburg, Magdeburg, Germany"},{"name":"Urologische Klinik, GLG Werner Forssmann Klinikum Eberswalde, Eberswalde, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulbaki","family":"Yakac","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie, Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Lusuardi","sequence":"additional","affiliation":[{"name":"Urology, Paracelsus Medizinische Privatuniversitat, Salzburg, Austria"},{"name":"Universit\u00e4tsklinik f\u00fcr Urologie und Andrologie, Uniklinikum Salzburg, Salzburg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Thomas","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie, Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semih","family":"Sarcan","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Universit\u00e4tsklinikum Schleswig-Holstein Campus L\u00fcbeck, Lubeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Burger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, Universit\u00e4t Regensburg Fakult\u00e4t f\u00fcr Medizin, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Axel S.","family":"Merseburger","sequence":"additional","affiliation":[{"name":"Urology, Universit\u00e4tsklinikum Schleswig-Holstein, Campus L\u00fcbeck, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Wiegland","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie, Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christain","family":"Gilfrich","sequence":"additional","affiliation":[{"name":"Urologische Klinik, St. Elisabeth-Klinikums Straubing, Straubing, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingmar","family":"Wolff","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Urologie, Universit\u00e4tsmedizin Greifswald, Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"May","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie, St. Elisabeth Klinikum Straubing, Straubing, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"ref3","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1007\/s00761-021-01002-w","article-title":"Das Zertifizierungssystem der Deutschen Krebsgesellschaft","volume":"27","author":"J R\u00fcckher","year":"2021","journal-title":"Der Onkologe"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"759362","DOI":"10.3389\/fonc.2021.759362","article-title":"Does the Identification of a Minimum Number of Cases Correlate With Better Adherence to International Guidelines Regarding the Treatment of Penile Cancer? 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