Smith Yuko, Hadway Paul, Ahmed Shwan, Perry Matthew J, Corbishley Catherine M, Watkin Nicholas A
Department of Urology, St George's Hospital, Tooting, London, UK.
BJU Int. 2007 Jul;100(1):82-7. doi: 10.1111/j.1464-410X.2007.06901.x. Epub 2007 May 4.
To evaluate medium-term outcome data from patients with distal urethral cancers treated with penile-preserving surgery.
We analysed prospectively 18 consecutive men referred for the management of urethral carcinoma. All had a specialist review in a supra-regional multidisciplinary team meeting, where the histology findings were reviewed by one pathology consultant. Tumours were staged according to the Tumour-Node-Metastasis classification and the patients offered penile-preserving surgery when tumours were limited to the glanular or penile urethra.
All 18 patients were suitable for penile-preserving surgery; the procedures were: three hypospadias formation with or without topical chemotherapy; four buccal mucosa urethroplasty; three glansectomy and reconstruction; six glansectomy, distal corporectomy, reconstruction and hypospadias formation; two urethrectomy with or with no excision of adjacent tunica albuginea. The mean (median, range) follow-up was 26 (20.5, 9-58) months. There were no local recurrences; four patients with regional nodal disease progressed and of these, two died from metastatic disease, and one died from an unrelated condition.
Medium-term data show that penile-preserving surgery is a feasible treatment for men with distal urethral carcinoma, providing excellent local control without prejudicing survival; a longer follow-up is needed.
评估接受保留阴茎手术治疗的远端尿道癌患者的中期结局数据。
我们前瞻性分析了18例因尿道癌前来治疗的连续男性患者。所有患者均在区域多学科团队会议上接受了专家评估，一名病理顾问对组织学检查结果进行了审查。肿瘤根据肿瘤-淋巴结-转移分类进行分期，当肿瘤局限于龟头或阴茎尿道时，为患者提供保留阴茎手术。
所有18例患者均适合保留阴茎手术；手术方式包括：3例进行尿道下裂成形术，伴或不伴局部化疗；4例进行颊黏膜尿道成形术；3例进行龟头切除术及重建术；6例进行龟头切除术、远端阴茎体切除术、重建术及尿道下裂成形术；2例进行尿道切除术，伴或不切除相邻白膜。平均（中位数，范围）随访时间为26（20.5，9 - 58）个月。无局部复发；4例区域淋巴结疾病患者病情进展，其中2例死于转移性疾病，1例死于无关疾病。
中期数据表明，保留阴茎手术对于远端尿道癌男性患者是一种可行的治疗方法，可提供良好的局部控制且不影响生存率；需要更长时间的随访。
