Tang Dominic H, Yan Sylvia, Ottenhof Sarah R, Draeger Désirée, Baumgarten Adam S, Chipollini Juan, Protzel Chris, Zhu Yao, Ye Ding-Wei, Hakenberg Oliver W, Horenblas Simon, Watkin Nicholas A, Spiess Philippe E
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL.
Department of Urology, St George's Healthcare NHS Trust, London, United Kingdom.
Urology. 2017 Nov;109:140-144. doi: 10.1016/j.urology.2017.08.004. Epub 2017 Aug 14.
To analyze the recurrence and survival outcomes of glansectomy in patients with penile squamous cell carcinoma.
We performed a retrospective review of 410 patients across 5 international tertiary referral centers between 1999 and 2016. All patients had tumors involving the glans penis and underwent glansectomy as primary treatment. The Kaplan-Meier method and log-rank test were used to calculate survival and recurrence. Median follow-up was 42 months (interquartile range [IQR] 29-56).
The median age was 64 years (IQR 53-72). Median tumor size was 2.2 cm (IQR 1.5-3.0). A total of 240 patients (58.5%) had pT2 disease, whereas only 43 patients (10.5%) had pT3 or pT4 disease. The majority of the cohort had poorly differentiated tumors (43.7%). Most recurrences were local at 7.6% (31 patients). Only 14 patients (3.4%) had regional recurrence and 9 patients (2.2%) had distant recurrence. When stratified by pathologic stage, tumors that were pT2 or higher were (P < .001) and were more likely to be poorly differentiated (P < .001). There were no differences in recurrence location among pathologic stages (P = .15). The 1-, 2-, and 5-year recurrence-free survival were 98%, 94%, and 78%, respectively. There were no differences in overall survival when stratified by stage (P = .67).
Glansectomy is an oncologically safe treatment modality for squamous cell carcinoma of the glans in appropriately selected invasive tumors.
分析阴茎鳞状细胞癌患者行龟头切除术的复发及生存结局。
我们对1999年至2016年间5个国际三级转诊中心的410例患者进行了回顾性研究。所有患者的肿瘤均累及阴茎头，并接受了龟头切除术作为主要治疗方法。采用Kaplan-Meier法和对数秩检验来计算生存率和复发率。中位随访时间为42个月（四分位间距[IQR]29 - 56）。
中位年龄为64岁（IQR 53 - 72）。中位肿瘤大小为2.2 cm（IQR 1.5 - 3.0）。共有240例患者（58.5%）患有pT2期疾病，而只有43例患者（10.5%）患有pT3或pT4期疾病。大多数队列患者患有低分化肿瘤（43.7%）。大多数复发为局部复发，占7.6%（31例患者）。只有14例患者（3.4%）出现区域复发，9例患者（2.2%）出现远处复发。按病理分期分层时，pT2期或更高分期的肿瘤（P <.001）且更可能为低分化（P <.001）。病理分期之间的复发部位无差异（P =.15）。1年、2年和5年无复发生存率分别为98%、94%和78%。按分期分层时总生存率无差异（P =.67）。
对于适当选择的浸润性肿瘤，龟头切除术是龟头鳞状细胞癌一种肿瘤学上安全的治疗方式。
