Korets Ruslan, Koppie Theresa M, Snyder Mark E, Russo Paul
Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA.
Ann Surg Oncol. 2007 Dec;14(12):3614-9. doi: 10.1245/s10434-007-9563-9. Epub 2007 Sep 26.
To present our institution's experience with squamous cell carcinoma (SCC) of the penis, with analysis of oncologic efficacy and survival.
Between 1989 and 2005, we identified 32 consecutive patients (median age, 61 years) with SCC of the penis managed with partial penectomy. Clinicopathologic variables were examined, and overall and disease-specific survival were determined.
Pathologic stage of the primary tumor was pTis in 1 patient (3%), pT1 in 11 (34%), pT2 in 16 (50%), and pT3 in 4 (13%). Pathologic grade was well differentiated in 9 patients (28%), moderately differentiated in 20 (63%), and poorly differentiated in 2 (6%). Twenty-five patients (78%) underwent inguinal lymph node dissection, with 15 (60%) demonstrating nodal metastases. Twenty-two patients (69%) underwent pelvic lymph node dissection; 21 were negative for pelvic nodal metastases, and 1 had grossly positive nodes. One patient developed local recurrence. After a mean follow-up of 34 months, overall survival was 56%. Numbers of patients alive and disease-free were 9 and 11 in the low-stage and advanced-stage groups, and 8 and 12 in the well and moderately differentiated groups, respectively. Both patients with poorly differentiated disease died of disease within 12 months from presentation.
Partial penectomy for SCC of the penis provides excellent local control, with low recurrence rate, and acceptable maintenance of urinary and sexual function. Outcomes are generally poor, however, for patients with regional metastases, even in moderately differentiated disease. Future studies are needed to identify a reliable method of predicting regional metastases.
介绍我院阴茎鳞状细胞癌（SCC）的治疗经验，并分析肿瘤学疗效和生存率。
1989年至2005年间，我们确定了32例连续接受部分阴茎切除术治疗的阴茎SCC患者（中位年龄61岁）。检查临床病理变量，并确定总生存率和疾病特异性生存率。
原发肿瘤的病理分期为pTis 1例（3%），pT1 11例（34%），pT2 16例（50%），pT3 4例（13%）。病理分级为高分化9例（28%），中分化20例（63%），低分化2例（6%）。25例患者（78%）接受了腹股沟淋巴结清扫术，其中15例（60%）有淋巴结转移。22例患者（69%）接受了盆腔淋巴结清扫术；21例盆腔淋巴结转移阴性，1例有肉眼可见的阳性淋巴结。1例患者出现局部复发。平均随访34个月后，总生存率为56%。低分期组和高分期组存活且无疾病的患者数分别为9例和11例，高分化组和中分化组分别为8例和12例。2例低分化疾病患者均在出现症状后12个月内死于该病。
阴茎SCC的部分阴茎切除术可实现良好的局部控制，复发率低，且能较好地维持泌尿和性功能。然而，即使是中分化疾病，有区域转移的患者预后通常较差。需要进一步研究以确定一种可靠的预测区域转移的方法。
