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两种早期阴茎癌保器官手术的对比研究:广泛局部切除术与部分阴茎切除术。

A Comparative study of two types of organ-sparing surgeries for early stage penile cancer: Wide local excision vs partial penectomy.

机构信息

Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.

Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China.

出版信息

Eur J Surg Oncol. 2018 Sep;44(9):1425-1431. doi: 10.1016/j.ejso.2018.03.021. Epub 2018 Apr 3.

Abstract

INTRODUCTION

Till date, there have been few reports of comparative studies on the outcomes of these different treatment modalities. In this study, we have aimed to comparatively evaluate the quality-of-life parameters, including sexual function, urinary function, and health-related quality of life (HRQOL), in patients with early stage penile cancers who underwent two different organ-sparing surgeries.

MATERIAL AND METHODS

From March 2012 to March 2015, we enrolled 15 patients with early stage penile cancers who underwent either wide local excision or partial penectomy as organ-sparing surgical treatments. We assessed their sexual and urinary functions and their HRQOL, using the International Index of Erectile Function (IIEF-15), Self-Esteem and Relationship (SEAR), and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaires and urodynamic determinations, and comparatively analyzed the outcomes of these patients who underwent either type of surgery.

RESULTS

All patients who underwent these two types of surgeries experienced satisfactory outcomes. The patients who underwent wide local excision performed relatively better, in terms of their sexual functions, urinary functions, and HRQOL, but no statistically significant differences were observed in the data collected via the IIEF-15, SEAR, EDITS, and EORTC-QLQ-C30 questionnaires and urodynamic determinations (p > 0.05), except in the data corresponding to the orgasmic function (p = 0.033).

CONCLUSION

Both types of organ-sparing surgeries assessed in this study achieved good outcomes, in terms of the aesthetics, sexual functions, urinary functions, and HRQOL in patients, without compromising the therapeutic effects of these surgeries. However, the observed decreases in orgasmic function will need to be addressed further.

摘要

介绍

迄今为止,关于这些不同治疗方式的结果比较研究报告甚少。在本研究中,我们旨在比较评估生活质量参数,包括性功能、尿功能和健康相关生活质量(HRQOL),这些参数在接受两种不同保器官手术的早期阴茎癌患者中的表现。

材料与方法

2012 年 3 月至 2015 年 3 月,我们招募了 15 名早期阴茎癌患者,他们接受了广泛局部切除术或部分阴茎切除术作为保器官手术治疗。我们使用国际勃起功能指数(IIEF-15)、自尊和关系(SEAR)以及治疗满意度勃起功能障碍问卷(EDITS)和尿动力学测定评估了他们的性和尿功能以及 HRQOL,并比较分析了接受这两种类型手术的患者的结果。

结果

所有接受这两种手术的患者都取得了满意的结果。接受广泛局部切除术的患者在性功能、尿功能和 HRQOL 方面表现相对较好,但通过 IIEF-15、SEAR、EDITS 和 EORTC-QLQ-C30 问卷和尿动力学测定收集的数据无统计学显著差异(p>0.05),除了在与性高潮功能相关的数据(p=0.033)。

结论

在本研究中评估的两种保器官手术在美学、性功能、尿功能和患者的 HRQOL 方面都取得了良好的效果,而不会影响这些手术的治疗效果。然而,观察到的性高潮功能下降需要进一步解决。

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