Penile Cancer

2. METHODS

2.1. Data identification

For the 2026 Penile Cancer Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. Comprehensive literature searches were carried out for all sections. Databases searched included Medline, EMBASE and the Cochrane Libraries, covering a time frame between 1 February 2022 and 1 May 2025. A total of 1,696 unique records were identified, retrieved and screened for relevance. A total of 55 new references were added to the 2026 Penile Cancer Guidelines. A detailed search strategy is available online: https://uroweb.org/guidelines/penile-cancer/publications-appendices.

Recommendations within the Guidelines are developed by the Panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms that accompany each Guidelines recommendation, addresses a number of key elements:

1. the overall quality of the evidence that exists for the recommendation [5];
2. the magnitude of the effect (individual or combined effects);
3. the certainty of the results (precision, consistency, heterogeneity and other statistical or study-related factors);
4. the balance between desirable and undesirable outcomes;
5. the impact of patient values and preferences on the intervention; and
6. the certainty of those patient values and preferences.

Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [6].

Additional methodology information and a list of associations endorsing the EAU Guidelines can be found online: https://uroweb.org/eau-guidelines/methodology-policies.

2.2. Review and future goals

The 2023 Guidelines document was subjected to peer-review prior to publication. The next peer-review is scheduled for 2028. Publications ensuing from published systematic reviews have all been peer reviewed.