Håkansson Ulf, Kirrander Peter, Uvelius Bengt, Baseckas Gediminas, Torbrand Christian
Department of Urology, Skåne University Hospital , Malmö , Sweden.
Scand J Urol. 2015 Apr;49(2):149-54. doi: 10.3109/21681805.2014.955822. Epub 2014 Oct 14.
The aim of this study was to present early outcome data for patients treated for penile cancer with organ-sparing reconstructive surgery at two referral centres in Sweden.
Oncological, cosmetic and functional outcome and complications were analysed retrospectively during the period 2011-2013. Twelve patients with non-invasive penile cancer were treated with glans resurfacing (GR), while 15 patients with invasive penile cancer underwent total glansectomy with neoglans reconstruction (TGN).
The 12 patients treated with GR had a median age of 66 years (range 35-83 years) and a median follow-up time of 16 months (range 4-40 months). All patients showed carcinoma in situ and negative surgical margins in the final pathology report. The 15 patients treated with TGN had a median age of 71 years (range 37-78 years) and the median follow-up time was 10 months (range 1-25 months). All patients had invasive penile cancer and the surgical margins were negative in all cases except one. Complications occurred in five of the 27 patients (18%), and in most cases these were minor and infection related. No recurrences were seen in either group during follow-up, and all patients except one, who had undergone GR, were satisfied with the functional and cosmetic results.
GR and TGN seem to be oncologically safe procedures for treating carefully selected patients with penile cancer, and the functional and cosmetic results are promising. Based on these findings, the authors recommend that penile amputation should only be carried out in patients who are not suitable for organ-sparing reconstructive surgery.
本研究的目的是呈现瑞典两个转诊中心接受保留器官重建手术治疗阴茎癌患者的早期结果数据。
对2011年至2013年期间的肿瘤学、美容和功能结果及并发症进行回顾性分析。12例非浸润性阴茎癌患者接受了龟头重建术(GR),而15例浸润性阴茎癌患者接受了全龟头切除术并进行了新龟头重建术(TGN)。
接受GR治疗的12例患者中位年龄为66岁(范围35 - 83岁),中位随访时间为16个月(范围4 - 40个月)。所有患者在最终病理报告中均显示原位癌且手术切缘阴性。接受TGN治疗的15例患者中位年龄为71岁(范围37 - 78岁),中位随访时间为10个月(范围1 - 25个月)。所有患者均患有浸润性阴茎癌,除1例患者外所有病例手术切缘均为阴性。27例患者中有5例(18%)发生并发症,大多数情况下这些并发症为轻微且与感染相关。随访期间两组均未观察到复发,除1例接受GR治疗的患者外,所有患者对功能和美容结果均满意。
GR和TGN对于精心挑选的阴茎癌患者似乎是肿瘤学上安全的手术,其功能和美容结果很有前景。基于这些发现,作者建议仅对不适合保留器官重建手术的患者进行阴茎截肢术。