Bayles Andrew C, Sethia Krishna K
Department of Urology, Norfolk and Norwich University NHS Trust, Norwich, UK.
Ann R Coll Surg Engl. 2010 Jan;92(1):44-5. doi: 10.1308/003588410X12518836439047.
The Improving Outcomes Guidance (IOG) for patients with carcinoma of the penis states that treatment should be provided supraregionally to populations of 4 million or greater who treat over 25 cases of penis cancer each year. This study assesses the impact of this guidance on the management and outcomes of patients with the disease in our region.
We retrospectively compared the records of 44 patients with carcinoma of the penis treated in our institution between 1969 and 1990 with 101 patients treated between 2002 and 2006, i.e. after supraregional centralisation of the service.
There was no significant change in the stage or grade of the tumours. However, the results show that, in modern times, there was a significant increase in the amount of penis-preserving and nodal surgery as well as a fall in mortality. The improved survival is greatest in patients with poorly-differentiated disease who may, therefore, have benefited from aggressive nodal surgery.
The centralisation of surgery for carcinoma of the penis results in improved outcomes both in terms of penis preservation and improved survival and this supports the IOG guidance.
阴茎癌患者的改善预后指南（IOG）指出，对于每年治疗超过25例阴茎癌病例的400万及以上人口，应在区域以上层面提供治疗。本研究评估了该指南对我们地区该病患者管理及预后的影响。
我们回顾性比较了1969年至1990年间在我们机构接受治疗的44例阴茎癌患者的记录与2002年至2006年间（即在服务进行区域以上层面集中化之后）接受治疗的101例患者的记录。
肿瘤的分期或分级没有显著变化。然而，结果显示，在现代，保留阴茎和淋巴结手术的数量显著增加，死亡率下降。在低分化疾病患者中，生存率的提高最为显著，因此他们可能从积极的淋巴结手术中获益。
阴茎癌手术的集中化在保留阴茎和提高生存率方面都带来了更好的预后，这支持了IOG指南。
