Leijte Joost A P, Horenblas Simon
Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
World J Urol. 2009 Apr;27(2):151-4. doi: 10.1007/s00345-008-0308-6. Epub 2008 Aug 9.
Accurate tumor staging is essential in the management of malignancies. It provides a guide in selecting accurate treatment and gives an indication of prognosis based on the extent of disease. The current TNM classification for penile carcinoma has remained unchanged since 1987. In this article, we focus on several deficiencies of the current classification.
An analysis of the current literature regarding the current classification was done, focusing on known prognostic factors for survival. Furthermore, we discuss in detail the results from a recent analysis of more than 500 patients treated at our institute to evaluate the practical and prognostic value of the TNM-classification.
We found that, using the current classification system, accurate clinical staging is often difficult, because the T and N categories are defined by structures that are not easily identified using physical examination or imaging. Furthermore, the prognostic stratification of the present staging system is not optimal and there is a substantial overlap in disease-specific survival between several categories. We give an overview of modifications that could improve clinical staging and prognostic ability.
The current TNM classification for penile carcinoma has several shortcomings in terms of usability in clinical staging and prognostic value. With modifications clinical staging is facilitated, while the prognostic stratification of the classification is improved.
准确的肿瘤分期对于恶性肿瘤的治疗至关重要。它为选择准确的治疗方法提供指导，并根据疾病范围提示预后情况。阴茎癌的现行TNM分类自1987年以来一直未变。在本文中，我们聚焦于现行分类的几个不足之处。
对有关现行分类的当前文献进行了分析，重点关注已知的生存预后因素。此外，我们详细讨论了对我院治疗的500多名患者的近期分析结果，以评估TNM分类的实用性和预后价值。
我们发现，使用现行分类系统时，准确的临床分期往往很困难，因为T和N类别是由体格检查或影像学不易识别的结构定义的。此外，现行分期系统的预后分层并不理想，几个类别之间的疾病特异性生存率存在大量重叠。我们概述了可以改善临床分期和预后能力的修改方法。
阴茎癌的现行TNM分类在临床分期的可用性和预后价值方面存在若干缺点。通过修改，临床分期变得更容易，同时分类的预后分层得到改善。
