Bañón Pérez V J, Nicolás Torralba J A, Valdelvira Nadal P, Server Pastor G, García Hernández J A, Guardiola Mas A, Gomez Gomez G, Prieto Gonzalez A, Martínez Barba E, Pérez Albacete M
Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
Arch Esp Urol. 2000 Oct;53(8):693-9.
To present our experience with squamous cell carcinoma of the penis.
We reviewed our series of 73 squamous cell carcinoma of the penis over the last 23 years. Patient mean age was 65.7 years. All lesions had been previously biopsied. Patient records were reviewed for a history of phimosis and related lesions. The histological, clinical and therapeutic aspects, and survival are analyzed.
Most of the squamous cell carcinoma of the penis were superficial lesions (pT1). Treatment was by partial penile resection in 42 cases, total penile resection in 9, and emasculation in 2 cases. Conservative surgery was performed in 20 cases (tumor excision in 14 and posthectomy in 6 cases). Lymphadenectomy was performed in 11 patients. Eight patients received radiotherapy to the inguinal region. The rate of recurrence after surgery was 11% (8 cases). Five of the 8 patients with tumor recurrence had been treated by conservative surgery. The 5-year survival rate was 78%.
Penile cancer is uncommon and accounts for less than 1% of tumors in the male in our setting. A higher incidence has been found in men with phimosis, poor hygiene and low sociocultural level. Partial penile resection is the treatment of choice for the primary lesion. The outcome is worse in patients with invasive tumor, poor cell differentiation, ulceroendophytic morphology, and above all in patients with metastatic adenopathy. Radiotherapy provided no benefits, made inguinal evaluation difficult and increased the morbidity in some cases. Patients with pT1 tumor and good cell differentiation showed no metastatic adenopathy during follow-up. Patient follow-up is fundamental to detect recurrence or metastatic adenopathy and to institute treatment immediately.
介绍我们在阴茎鳞状细胞癌方面的经验。
我们回顾了过去23年里收治的73例阴茎鳞状细胞癌病例。患者的平均年龄为65.7岁。所有病变均已先行活检。查阅患者记录以了解包茎及相关病变史。对组织学、临床、治疗方面及生存率进行分析。
大多数阴茎鳞状细胞癌为浅表病变(pT1)。42例行部分阴茎切除术,9例行全阴茎切除术,2例行去势术。20例行保守手术(14例行肿瘤切除术,6例行包皮环切术后肿瘤切除术)。11例患者行淋巴结清扫术。8例患者接受腹股沟区放疗。术后复发率为11%(8例)。8例肿瘤复发患者中有5例接受了保守手术治疗。5年生存率为78%。
阴茎癌并不常见,在我们的研究中占男性肿瘤的比例不到1%。在包茎、卫生条件差和社会文化水平低的男性中发病率较高。部分阴茎切除术是原发性病变的首选治疗方法。浸润性肿瘤、细胞分化差、溃疡内生性形态的患者,尤其是有转移性淋巴结病的患者,预后较差。放疗没有益处,使腹股沟评估困难,且在某些情况下增加了发病率。pT1肿瘤且细胞分化良好的患者在随访期间未出现转移性淋巴结病。对患者进行随访对于发现复发或转移性淋巴结病并立即进行治疗至关重要。