Mistry Tina, Jones Rob W A, Dannatt Erica, Prasad Krishna K, Stockdale Andrew D
Department of Urology, University Hospital Coventry and Warwickshire, Coventry, UK.
BJU Int. 2007 Dec;100(6):1277-81. doi: 10.1111/j.1464-410X.2007.07168.x. Epub 2007 Sep 10.
To audit the penile cancer workload, management and outcome within a regional cancer network serving a population of approximately 1 million in the West Midlands (UK), comparing these data to that published by the British Association of Urological Surgeons National Cancer Registry, the UK National Institute of Clinical Excellence and the European Associations of Urology guidelines.
Patients diagnosed with or treated for penile cancer within the Arden Cancer Network over a 10-year period were identified retrospectively, and data relating to histology, local treatment, lymph node management, outcome and survival were recorded.
Data were obtained for 65 patients; 61 (94%) had histologically confirmed squamous cell carcinoma (SCC) of the penis, equating to approximately 0.6 cases per 100 000 population per year. Their mean age at diagnosis was 63 years. Of SCCs, 86% were located on the glans and/or foreskin. Thirty-six patients had conservative primary local therapy, mostly for T0 or T1 disease. The 5-year relapse-free survival after radiotherapy was 63%, although survival after salvage penectomy was 75% at 4 years. Forty-seven patients had lymph node surveillance; 11 developed lymph node disease and had lymph node dissection (LND) with or with no radiotherapy, but survival was poor. Primary inguinal LND with or without radiotherapy was used in eight patients, and was associated with a good survival, although three were found to have negative histology after LND. Survival was strongly influenced by T and N stage at presentation and the 5-year survival for the whole group was 71%.
The workload, incidence and overall mortality from penile cancer within the Arden Cancer Network are in line with those in the rest of the UK. Rates of conservative therapy were good in this group and associated with good survival. Survival could be improved by identifying and aggressively treating those patients at high risk of lymph node disease.
审核在为西米德兰兹郡（英国）约100万人口服务的区域癌症网络内阴茎癌的工作量、管理情况及治疗结果，并将这些数据与英国泌尿外科医师协会国家癌症登记处、英国国家临床优化研究所及欧洲泌尿外科协会指南所公布的数据进行比较。
回顾性确定在阿登癌症网络内10年间被诊断为阴茎癌或接受阴茎癌治疗的患者，并记录与组织学、局部治疗、淋巴结管理、治疗结果及生存率相关的数据。
获取了65例患者的数据；61例（94%）经组织学确诊为阴茎鳞状细胞癌（SCC），相当于每年每10万人口约0.6例。他们确诊时的平均年龄为63岁。在SCC患者中，86%位于龟头和/或包皮。36例患者接受了保守的原发性局部治疗，主要针对T0或T1期疾病。放疗后的5年无复发生存率为63%，不过挽救性阴茎切除术后4年的生存率为75%。47例患者接受了淋巴结监测；11例出现淋巴结疾病并接受了淋巴结清扫术（LND），无论是否接受放疗，但其生存率较低。8例患者接受了原发性腹股沟LND，无论是否接受放疗，其生存率良好，不过3例在LND后组织学检查结果为阴性。生存率受就诊时T和N分期的强烈影响，整个组别的5年生存率为71%。
阿登癌症网络内阴茎癌的工作量、发病率及总体死亡率与英国其他地区一致。该组患者的保守治疗率良好，且生存率较高。通过识别并积极治疗那些有淋巴结疾病高风险的患者，生存率有望提高。
