Rippentrop Jonathan M, Joslyn Sue A, Konety Badrinath R
Department of Urology, The University of Iowa, Iowa City 52242-1089, USA.
Cancer. 2004 Sep 15;101(6):1357-63. doi: 10.1002/cncr.20519.
Penile carcinoma is uncommon. Therefore, obtaining meaningful epidemiologic data requires analysis of large, multisource databases. The authors examined the association between different demographic variables and the prevalence, presentation, and survival of patients with penile squamous cell carcinoma in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database.
The SEER database represents 12% of the U.S. population. The database included 1605 patients with a diagnosis of penile squamous cell carcinoma between 1973 and 1998. The variables analyzed were age, race, marital status, stage at presentation, type of surgery, performance of lymphadenectomy, and disease-specific survival.
Of 1605 patients, 37% presented with carcinoma in situ (CIS), 39% with localized disease, 13% with regional disease, 2.3% with distant disease, and 7.9% of the patients were unstaged. The percentage of patients presenting with CIS and localized disease increased and decreased yearly, respectively. African Americans represented 9.9% of the population and tended to present at a younger age and with a higher stage of disease, and their cancer-specific survival was shorter in all stages. However, these associations were statistically significant only for men with regional disease. Marital status was documented for 1394 patients (87%). The majority (84%) had a history of marriage and presented at an earlier stage of disease and had higher disease-specific survival in the localized (P = 0.0002) and regional stages (P = 0.0010) of disease.
The diagnosis of penile carcinoma significantly reduced survival. African-American men presented with a higher stage of disease and statistically significant decreased survival, whereas previously or currently married men presented at an earlier stage of disease and sought more aggressive treatment.
阴茎癌并不常见。因此，要获得有意义的流行病学数据需要分析大型多源数据库。作者在美国国立癌症研究所的监测、流行病学和最终结果（SEER）数据库中研究了不同人口统计学变量与阴茎鳞状细胞癌患者的患病率、临床表现和生存率之间的关联。
SEER数据库代表了美国12%的人口。该数据库纳入了1973年至1998年间1605例诊断为阴茎鳞状细胞癌的患者。分析的变量包括年龄、种族、婚姻状况、就诊时的分期、手术类型、淋巴结清扫情况以及疾病特异性生存率。
1605例患者中，37%为原位癌（CIS），39%为局限性疾病，13%为区域性疾病，2.3%为远处疾病，7.9%的患者分期不明。表现为CIS和局限性疾病的患者百分比分别逐年增加和减少。非裔美国人占总人口的9.9%，倾向于在较年轻时发病且疾病分期较高，并且他们在所有分期的癌症特异性生存率都较短。然而，这些关联仅在患有区域性疾病的男性中具有统计学意义。1394例患者（87%）记录了婚姻状况。大多数（84%）有婚姻史，疾病分期较早，在疾病的局限性（P = 0.0002）和区域性阶段（P = 0.0010）疾病特异性生存率较高。
阴茎癌的诊断显著降低了生存率。非裔美国男性疾病分期较高且生存率有统计学意义的降低，而既往或目前已婚的男性疾病分期较早且寻求更积极的治疗。
