Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany.
Urol Oncol. 2011 Nov-Dec;29(6):782-7. doi: 10.1016/j.urolonc.2009.08.022. Epub 2009 Nov 27.
Due to the low prevalence of penile cancer, little evidence exists on the metastatic potential and the ideal treatment strategies in intermediate-differentiated invasive (pT1 G2) penile cancer. The current study aimed to analyze the oncologic outcome of patients with penile carcinoma with long-term follow-up in a single-center study.
In this retrospective study, 38 patients with histologically proven T1 G2 squamous cell carcinoma of the penis were included. Only the 'classic' subtype was analyzed. Treatment of the primary tumor was Nd:YAG laser-therapy, excision, or partial amputation. Follow-up was performed according to EAU guidelines (2004).
Mean follow-up was 78.1 months (range: 9-285 months). Local recurrence was seen in 12 patients (31.6%), but was not correlated with disease related death (P = 0.7944). Rate of local recurrence was not dependent on treatment modality (P = 0.3481); 13 patients died, accounting for a disease related survival rate of 81.6% during observation period. Positive lymph nodes were seen in 28.9% of patients and were significantly correlated with disease related death (P = 0.00004). Clinically enlarged inguinal lymph nodes were not correlated with histologically confirmed positive lymph nodes (P = 0.5785).
For patients with T1 G2 penile cancer, organ preserving therapy appears to be a suitable treatment option. In our series, nearly one third of patients developed inguinal lymph node metastases, which highlights the potential benefit of surgical staging. Larger prospective multicenter studies are needed to define the best treatment strategy for intermediate-differentiated invasive penile cancer.
由于阴茎癌的发病率较低，因此在中分化浸润性（pT1 G2）阴茎癌中，关于其转移潜能和理想治疗策略的证据有限。本研究旨在通过单中心研究分析长期随访的阴茎癌患者的肿瘤学结果。
在这项回顾性研究中，纳入了 38 例经组织学证实的 T1 G2 阴茎鳞状细胞癌患者。仅分析了“经典”亚型。肿瘤的主要治疗方式包括 Nd:YAG 激光治疗、切除或部分截肢。随访根据 EAU 指南（2004 年）进行。
平均随访时间为 78.1 个月（范围：9-285 个月）。12 例患者（31.6%）出现局部复发，但与疾病相关死亡无相关性（P = 0.7944）。局部复发率与治疗方式无关（P = 0.3481）；13 例患者死亡，观察期间疾病相关生存率为 81.6%。28.9%的患者出现阳性淋巴结，与疾病相关死亡显著相关（P = 0.00004）。临床可触及的腹股沟淋巴结与组织学证实的阳性淋巴结无相关性（P = 0.5785）。
对于 T1 G2 阴茎癌患者，保留器官的治疗似乎是一种合适的治疗选择。在我们的研究中，近三分之一的患者出现腹股沟淋巴结转移，这突出了手术分期的潜在益处。需要更大的前瞻性多中心研究来确定中分化浸润性阴茎癌的最佳治疗策略。
