Mahmud A, Qu X, Yip D, Leveridge M, Mackillop W
Department of Oncology, Queen's University, Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, Ontario, Canada.
Department of Oncology, Queen's University, Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, Ontario, Canada.
Clin Oncol (R Coll Radiol). 2017 Apr;29(4):239-247. doi: 10.1016/j.clon.2016.12.006. Epub 2017 Jan 3.
Penile cancer is a rare malignancy in Western countries. The management guidelines are mainly derived from retrospective studies as there are no randomised trials. The primary objective of this study was to assess patterns of practice and outcomes of penile squamous cell carcinoma in Ontario. Secondary objectives included examining trends in incidence, pathological characteristics and prognostic factors.
All patients diagnosed with penile cancer between 2000 and 2010 were identified from the Ontario Cancer Registry and all available pathology reports related to penile cancer during this period were reviewed.
Pathology reports of 419 new cases of penile squamous cell carcinoma were reviewed. There was a significant improvement in completeness of the pathology reports in recent years. The age-adjusted incidence was 0.9 per 100 000 person-years. Most patients presented with a pT1 lesion (63%). A partial penectomy (40%) was the most common surgical procedure. Over 38% of patients identified to be eligible for organ-sparing surgery had a total or partial penectomy. Only 23% of the eligible patients identified to require lymph node dissection underwent the procedure. The 5 year disease-specific survival for stage 0, I, II, III were 94%, 93%, 74% and 52%, respectively.
There is a significant variation in the patterns of practice in Ontario. A large proportion of patients in this cohort were probably overtreated for the primary malignancy and undertreated for the regional nodes.
阴茎癌在西方国家是一种罕见的恶性肿瘤。由于缺乏随机试验，管理指南主要源自回顾性研究。本研究的主要目的是评估安大略省阴茎鳞状细胞癌的治疗模式和结果。次要目的包括研究发病率、病理特征和预后因素的趋势。
从安大略癌症登记处识别出2000年至2010年间所有被诊断为阴茎癌的患者，并回顾了这一时期所有与阴茎癌相关的可用病理报告。
回顾了419例阴茎鳞状细胞癌新病例的病理报告。近年来病理报告的完整性有显著改善。年龄调整后的发病率为每10万人年0.9例。大多数患者表现为pT1病变（63%）。部分阴茎切除术（40%）是最常见的手术方式。在确定 eligible for organ-sparing surgery的患者中，超过38%接受了全阴茎切除术或部分阴茎切除术。在确定需要进行淋巴结清扫的 eligible patients中，只有23%接受了该手术。0期、I期、II期、III期的5年疾病特异性生存率分别为94%、93%、74%和52%。
安大略省的治疗模式存在显著差异。该队列中的很大一部分患者可能对原发性恶性肿瘤治疗过度，而对区域淋巴结治疗不足。
