Beech Benjamin, Izawa Jonathan, Pautler Stephen, Chin Joseph, Power Nicholas
Schulich School of Medicine and Dentistry, Western University, London, ON;
Division of Urology, Department of Surgery, Western University, London, ON;
Can Urol Assoc J. 2015 Sep-Oct;9(9-10):315-9. doi: 10.5489/cuaj.3230.
Penile squamous cell carcinoma (SCC) is rare in North America; however, the morbidity can be devastating. This analysis represents the first reported penile cancer experience at a tertiary care centre in Canada.
We carried out a retrospective review of all patients who received care at our centre for penile SCC from 2005 until the present time. Epidemiological and clinical data were collected for all patients. Survival analysis was performed using Kaplan-Meier methods with log-rank test and Cox regression for univariate and multivariate analysis, respectively.
We identified 42 patients who were treated at our centre for penile SCC. Of these, 29% underwent excisional biopsy, 38% had partial penectomy, and 33% had total penectomy. Five patients with high-risk tumours underwent modified inguinal lymph node dissection (ILND), while 7 patients had radical ILND for clinically palpable disease. Overall, the median cancer specific survival (CSS) was undefined, with a 60% survival at 102 months. However CSS was significantly correlated to pT stage, pN stage, and tumour grade. The median follow-up was 25 months (interquartile range: 11-48).
These findings confirm the poor CSS of patients with positive lymph nodes in penile SCC. Patients with pN0 after ILND had a durable CSS. Risk factors for penile SCC were confirmed as elevated body mass index, positive smoking history, and lack of circumcision. This first epidemiologic report on penile SCC from a Canadian tertiary care centre should be expanded to other national centres.
阴茎鳞状细胞癌（SCC）在北美较为罕见；然而，其发病率可能具有毁灭性。本分析代表了加拿大一家三级医疗中心首次报告的阴茎癌治疗经验。
我们对2005年至今在我们中心接受阴茎SCC治疗的所有患者进行了回顾性研究。收集了所有患者的流行病学和临床数据。分别采用Kaplan-Meier方法进行生存分析，使用对数秩检验和Cox回归进行单因素和多因素分析。
我们确定了42例在我们中心接受阴茎SCC治疗的患者。其中，29%接受了切除活检，38%进行了部分阴茎切除术，33%进行了全阴茎切除术。5例高危肿瘤患者接受了改良腹股沟淋巴结清扫术（ILND），7例临床可触及病变患者接受了根治性ILND。总体而言，癌症特异性生存中位数（CSS）未确定，102个月时生存率为60%。然而，CSS与pT分期、pN分期和肿瘤分级显著相关。中位随访时间为25个月（四分位间距：11 - 48）。
这些发现证实了阴茎SCC淋巴结阳性患者的CSS较差。ILND后pN0患者的CSS持久。阴茎SCC的危险因素被确认为体重指数升高、吸烟史阳性和未行包皮环切术。这份来自加拿大三级医疗中心的关于阴茎SCC的首次流行病学报告应扩展至其他国家中心。
