Department of Andrology and Genito-urethral Reconstruction, University College London Hospital, London, UK.
Clin Oncol (R Coll Radiol). 2010 Nov;22(9):747-54. doi: 10.1016/j.clon.2010.07.010. Epub 2010 Aug 25.
Advanced genital tumours are rare. Traditionally, surgical intervention in these patients has had a limited role due to the associated co-morbidities, poor performance status and overall poor prognosis. Because the potential benefit of surgical intervention in advanced cases is not evidence based, a large proportion of these patients are treated palliatively with chemoradiation therapy, which may have a limited role in advanced disease together with no significant improvement in quality of life for the patient. We present a review of palliative surgical techniques and non-surgical interventions in a range of male genital malignancies. Although the focus relates to advanced tumours with a palliative intent, a brief discussion on treatment with a view to cure is also covered. The traditional dogma is challenged with demonstration of value in surgery as part of multimodal therapy. Various surgical techniques that are used not only to excise the primary tumour, but also those of reconstruction of the urinary tract as well as techniques of flap and graft-based coverage are described. We show the essential role of surgery as part of multimodal therapy in well-motivated patients. No longer is surgery considered as having a limited role in these patients with advanced male genital malignancy.
晚期生殖系统肿瘤较为罕见。由于这些患者常合并多种疾病、身体状况不佳且总体预后较差，传统上，手术干预在这些患者中的作用有限。由于晚期病例中手术干预的潜在获益并无确切证据，因此，大多数此类患者采用放化疗姑息治疗，而对于晚期疾病，该方法的作用有限，且对患者的生活质量并无明显改善。本文对一系列男性生殖系统恶性肿瘤的姑息性手术技术和非手术干预进行了综述。尽管重点在于姑息性治疗的晚期肿瘤，但也简要讨论了旨在治愈的治疗方法。通过将手术作为多模态治疗的一部分来证明其价值，对传统观念提出了挑战。本文介绍了不仅用于切除原发性肿瘤，而且还用于重建泌尿道以及皮瓣和移植物覆盖技术的各种手术技术。我们展示了在有强烈治疗意愿的患者中，手术作为多模态治疗的一部分所发挥的重要作用。对于晚期男性生殖系统恶性肿瘤患者，手术不再被认为作用有限。
