García Rodríguez Jorge, Fernández Gómez Jesús María, Rodríguez Martínez Juan Javier, Rodríguez Faba Oscar, Jalón Monzón Antonio, San Martín Blanco Alfonso, Martínez Gómez Francisco J, Sánchez Trilla Alberto, Martín Benito Jose Luis, Escaf Barmadah Safwan, Regadera Sejas Javier
Servicio de Urología I, Hospital Central de Asturias, Oviedo, España.
Arch Esp Urol. 2003 Jan-Feb;56(1):30-6.
To study the evolution of 49 patients with squamous cell carcinoma of the penis.
49 patients who underwent surgery for squamous cell carcinoma of the penis (30 partial penile amputations, 11 total amputations and 7 circumcisions). 27 inguinal lymphadenectomies, superficial, profound and ilio-obturator (2 cases), were performed due to persistent lymph nodes after penile amputation despite of antibiotic treatment for 4 weeks, or to high grade primary tumour. 13 patients were found to have lymph node metastases after treatment, receiving posterior adjuvant treatment with radiotherapy, chemotherapy or a combination of them. Patients were followed in relation to stage, cell differentiation degree, and presence or absence of positive lymph nodes and distant metastases.
There were 5 Ta stage tumours, 26 T1(63.2%), 16 T2 (32.6%), and 2 T3 (4.08%). Regarding cytological degree 81% were GI, 16% G II, and 2% G III. Lymph node metastasis were detected in 13 patients (26.53%) after lymph node dissection. 6 patients died from tumour dissemination, 2 of them were T2G2, one T2G1, and three T1G2; two additional patients died from causes different from the tumour, all of them being N+ at the time of diagnosis.
Penile squamous cell carcinoma is an aggressive tumour the evolution of which mainly depends on the local-regional stage at the time of diagnosis and cell differentiation; these factors will condition lymphadenectomy versus observation.
研究49例阴茎鳞状细胞癌患者的病情发展。
49例接受阴茎鳞状细胞癌手术的患者(30例行部分阴茎切除术,11例行全阴茎切除术,7例行包皮环切术)。27例行腹股沟淋巴结清扫术,包括浅表、深部及髂闭孔淋巴结清扫术(2例),原因是阴茎截肢术后尽管接受了4周抗生素治疗但仍有持续性淋巴结,或因原发性肿瘤分级高。13例患者在治疗后被发现有淋巴结转移,接受了放疗、化疗或两者联合的辅助治疗。对患者进行分期、细胞分化程度以及有无阳性淋巴结和远处转移方面的随访。
有5例Ta期肿瘤,26例T1期(63.2%),16例T2期(32.6%),2例T3期(4.08%)。在细胞学分级方面,81%为G1级,16%为G2级,2%为G3级。淋巴结清扫术后13例患者(26.53%)检测到淋巴结转移。6例患者死于肿瘤播散,其中2例为T2G2,1例为T2G1,3例为T1G2;另外2例患者死于与肿瘤无关的原因,诊断时均为N+。
阴茎鳞状细胞癌是一种侵袭性肿瘤,其病情发展主要取决于诊断时的局部区域分期和细胞分化;这些因素将决定是否进行淋巴结清扫术还是观察。