Miyao N, Kumamoto Y, Tsukamoto T, Ohmura K, Yamazaki K, Iwasawa M
Department of Urology, Sapporo Medical College.
Nihon Hinyokika Gakkai Zasshi. 1990 Oct;81(10):1550-4. doi: 10.5980/jpnjurol1989.81.1550.
Recent progress in molecular biology suggests a certain relationship between penile cancer and human papilloma virus infection. However, the treatment for penile cancer has not been established since each institute has experienced only a small number of patients. We analyzed the result of our treatment for 14 penile cancer patients during past twenty years. Ten of the 14 patients were initially treated for the primary lesion with a combination of peplomycin (PEP) or bleomycin (BLM) and radiation therapy. Of these, 9 were found not to have residual viable cancer cells in their primary lesions. No local recurrence was found in all 7 patients in whom the penis was preserved. This result suggests that combination of PEP (BLM) and radiation preserves the penis without increasing the risk of local recurrence. Penile cancer-related death did not occur in patients without lymph node metastasis. However, this cancer death did occur in 4 out of 7 patients with lymph node metastasis, suggesting that metastasis is one of the important prognostic factors. PEP (BLM) and radiation therapy with or without regional lymph node dissection did not improve the prognosis of patients with advanced penile carcinoma, such as with pN2, pN3 or distant metastasis. More effective management may be necessary for these patients.
分子生物学的最新进展表明阴茎癌与人类乳头瘤病毒感染之间存在一定关联。然而，由于各机构接诊的阴茎癌患者数量较少，阴茎癌的治疗方法尚未确立。我们分析了过去20年中14例阴茎癌患者的治疗结果。14例患者中有10例最初采用培普利霉素（PEP）或博来霉素（BLM）联合放射治疗原发性病变。其中，9例患者的原发性病变中未发现残留的存活癌细胞。在保留阴茎的所有7例患者中均未发现局部复发。这一结果表明，PEP（BLM）与放射治疗相结合可保留阴茎，且不会增加局部复发风险。无淋巴结转移的患者未发生阴茎癌相关死亡。然而，7例有淋巴结转移的患者中有4例发生了这种癌症死亡，这表明转移是重要的预后因素之一。对于晚期阴茎癌患者，如pN2、pN3或远处转移患者，无论是否进行区域淋巴结清扫，PEP（BLM）和放射治疗均未改善其预后。对于这些患者，可能需要更有效的治疗方法。
