Tan Teck Wei, Chia Sing Joo, Chong Kian Tai
Tan Tock Seng Hospital, Singapore, Singapore.
Arab J Urol. 2017 Mar 30;15(2):123-130. doi: 10.1016/j.aju.2017.03.001. eCollection 2017 Jun.
To present our experience of managing penile squamous cell carcinoma (SCC) in a tertiary hospital in Singapore and to evaluate the prognostic value of the inflammatory markers neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR).
We reviewed our prospectively maintained Institutional Review Board-approved urological cancer database to identify men treated for penile SCC at our centre between January 2007 and December 2015. For all the patients identified, we collected epidemiological and clinical data.
In all, 39 patients were identified who were treated for penile SCC in our centre. The median [interquartile range (IQR)] follow-up was 34 (16.5-66) months. Although very few (23%) of our patients with high-risk clinical node-negative underwent prophylactic inguinal lymph node dissection (ILND), they still had excellent 5-year recurrence-free survival (RFS; 90%) and cancer-specific survival (CSS; 90%). At multivariate analysis, higher N stage was significantly associated with worse RFS and CSS. Patients with a high NLR (≥2.8) had significantly higher T-stage ( = 0.006) and worse CSS ( < 0.001) than those with a low NLR. Patients with a low LMR (<3.3) had significantly higher T-stage ( = 0.013) and worse RFS ( = 0.009) and CSS ( < 0.022) than those with a high LMR.
Although very few of our patients with intermediate- and high-risk clinical node-negative SCC underwent prophylactic ILND, they still had excellent 5-year RFS and CSS. However, survival was poor in patients with node-positive disease. The pre-treatment NLR and LMR could serve as biomarkers to predict the prognosis of patients with penile cancer.
介绍我们在新加坡一家三级医院管理阴茎鳞状细胞癌（SCC）的经验，并评估炎症标志物中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与单核细胞比值（LMR）的预后价值。
我们回顾了前瞻性维护的、经机构审查委员会批准的泌尿外科癌症数据库，以确定2007年1月至2015年12月期间在我们中心接受阴茎SCC治疗的男性患者。对于所有确定的患者，我们收集了流行病学和临床数据。
我们中心共确定了39例接受阴茎SCC治疗的患者。中位随访时间[四分位间距（IQR）]为34（16.5 - 66）个月。尽管我们只有极少数（23%）高危临床淋巴结阴性的患者接受了预防性腹股沟淋巴结清扫术（ILND），但他们仍有出色的5年无复发生存率（RFS；90%）和癌症特异性生存率（CSS；90%）。多因素分析显示，较高的N分期与较差的RFS和CSS显著相关。与NLR较低的患者相比，NLR较高（≥2.8）的患者T分期显著更高（P = 0.006），CSS更差（P < 0.001）。与LMR较高的患者相比，LMR较低（<3.3）的患者T分期显著更高（P = 0.013），RFS更差（P = 0.009），CSS更差（P < 0.022）。
尽管我们只有极少数中高危临床淋巴结阴性的SCC患者接受了预防性ILND，但他们仍有出色的5年RFS和CSS。然而，淋巴结阳性疾病患者的生存率较差。治疗前的NLR和LMR可作为预测阴茎癌患者预后的生物标志物。
