Kang Minyong, Jeong Chang Wook, Kwak Cheol, Kim Hyeon Hoe, Ku Ja Hyeon
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Urology, Seoul National University Hospital, Seoul, Korea.
J Korean Med Sci. 2015 Aug;30(8):1143-9. doi: 10.3346/jkms.2015.30.8.1143. Epub 2015 Jul 15.
The aim of this study was to evaluate female urethral cancer (UCa) patients treated and followed-up during a time period spanning more than 20 yr at single institution in Korea. We reviewed medical records of 21 consecutive patients diagnosed with female UCa at our institution between 1991 and 2012. After exclusion of two patients due to undefined histology, we examined clinicopathological variables, as well as survival outcomes of 19 patients with female UCa. A Cox proportional hazards ratio model was used to identify significant predictors of prognosis according to variables. The median age at diagnosis was 59 yr, and the median follow-up duration was 87.0 months. The most common initial symptoms were voiding symptoms and blood spotting. The median tumor size was 3.4 cm, and 55% of patients had lesions involving the entire urethra. The most common histologic type was adenocarcinoma, and the second most common type was urothelial carcinoma. Fourteen patients underwent surgery, and 7 of these patients received adjuvant radiation or systemic chemotherapy. Eleven patients experienced tumor recurrence after primary therapy. Patients with high stage disease, advanced T stage (≥T3), and positive lymph nodes had worse survival outcomes compared to their counterparts. Particularly, lymph node positivity and advanced T stage were significant predictive factors for all survival outcomes. Tumor location was the only significant predictor for recurrence-free survival. Although our study included a small number of patients, it conveys valuable information about this rare female urologic malignancy in a Korean population.
本研究旨在评估在韩国一家机构接受治疗并随访超过20年的女性尿道癌(UCa)患者。我们回顾了1991年至2012年间在本机构连续诊断为女性UCa的21例患者的病历。排除2例组织学不明确的患者后,我们研究了19例女性UCa患者的临床病理变量以及生存结果。使用Cox比例风险模型根据变量确定预后的重要预测因素。诊断时的中位年龄为59岁,中位随访时间为87.0个月。最常见的初始症状是排尿症状和血尿。肿瘤中位大小为3.4 cm,55%的患者病变累及整个尿道。最常见的组织学类型是腺癌,第二常见的类型是尿路上皮癌。14例患者接受了手术,其中7例患者接受了辅助放疗或全身化疗。11例患者在初始治疗后出现肿瘤复发。与低分期疾病患者相比,高分期疾病、晚期T分期(≥T3)和淋巴结阳性的患者生存结果更差。特别是,淋巴结阳性和晚期T分期是所有生存结果的重要预测因素。肿瘤位置是无复发生存的唯一重要预测因素。尽管我们的研究纳入的患者数量较少,但它传达了有关韩国人群中这种罕见女性泌尿系统恶性肿瘤的有价值信息。