Ritchie Alastair W S, Foster Paul W, Fowler Sarah
Urology Department, Gloucestershire Royal Hospital, Gloucester, UK.
BJU Int. 2004 Dec;94(9):1248-52. doi: 10.1111/j.1464-410X.2004.05152.x.
To use the British Association of Urological Surgeons (BAUS) Cancer Registry data to audit a cohort of patients with penile cancer, and thus evaluate current management practices in the UK.
In all, 243 patients were registered over an 18-month period shortly before the publication of the UK National Institute of Clinical Excellence cancer guidelines. Clinical data, including preceding skin disorders, the clinical presentation, management, treatment-related complications and the outcome in terms of local, nodal or distant disease recurrence, survival and cause of death, were sought from the originating clinician.
Data were obtained on 193 patients (79% of the initial population). One consultant reported five patients and the most from one centre was eight. A painless lump or ulcer was the commonest presentation; 45 patients had pre-existing skin disorders. The median age was 65.5 years and 67 patients were aged < 60 years. Squamous cell carcinoma accounted for 94% of the pathology. There were wide variations in treatment for patients of similar disease stage. Twenty-six patients had palpable regional nodes and 44 had a lymph node dissection; complications were reported in 43, including 18 of 44 having node dissection. The median follow-up was 27.7 months from the date of diagnosis. Death from penile cancer was recorded in one of 22 patients with stage 0 disease and seven of nine with stage IV disease. Positive lymph nodes had a detrimental effect on survival.
Experience in the management of penile cancer is shared by many urological surgeons in the UK. These data provide a 'baseline' against which to measure the outcome of specialist multidisciplinary team activity.
利用英国泌尿外科医师协会（BAUS）癌症登记数据对一组阴茎癌患者进行审核，从而评估英国目前的治疗方法。
在英国国家临床优化研究所癌症指南发布前不久的18个月内，共登记了243例患者。从原诊治医生处获取临床数据，包括先前的皮肤疾病、临床表现、治疗、治疗相关并发症以及局部、淋巴结或远处疾病复发、生存和死亡原因等方面的结果。
获取了193例患者（占初始人群的79%）的数据。一名顾问报告了5例患者，一个中心报告最多的是8例。无痛性肿块或溃疡是最常见的表现；45例患者有既往皮肤疾病。中位年龄为65.5岁，67例患者年龄小于60岁。鳞状细胞癌占病理类型的94%。相似疾病分期患者的治疗方法差异很大。26例患者可触及区域淋巴结，44例行淋巴结清扫术；43例报告有并发症，其中44例行淋巴结清扫术的患者中有18例出现并发症。从诊断之日起的中位随访时间为27.7个月。22例0期疾病患者中有1例、9例IV期疾病患者中有7例死于阴茎癌。阳性淋巴结对生存有不利影响。
英国许多泌尿外科医师都有阴茎癌治疗经验。这些数据提供了一个“基线”，可据此衡量专科多学科团队活动的结果。
