Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia; Department of Urology, Fundación Santa Fe de Bogotá, Colombia.
Division of Urology, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia.
Urology. 2020 Aug;142:161-165.e1. doi: 10.1016/j.urology.2020.03.058. Epub 2020 May 5.
To describe oncological and functional outcomes in patients treated with reconstructive organ-sparing surgery (OSS) for squamous cell carcinoma of the penis. Plastic reconstructive OSS of the penis with a split thickness skin graft has been proposed as a treatment option for penile cancer, with the objective being preservation of physiological voiding and sexual function without comprising oncological control.
Multicenter study reporting clinicopathological data of 57 patients with malignant lesions of the penis treated with OSS and plastic reconstructive surgery with split thickness skin graft from 2007 to 2019. Health related quality of life (HRQoL) was assessed with EuroQoL-5D-3L, urinary symptoms with the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms, and erectile function with the International Index of erectile function (IIEF)-5.
Fifty-seven patients underwent OSS reconstructive surgery. Twenty underwent glans resurfacing, 23 partial penectomy, and 14 glansectomy. Median age was 55.1 years (interquartile range [IQR] 29-90), median follow-up 55.7 months (3-149). At the time of data analysis, 6 patients had died of Squamous Cell Carcinoma (SCC) (12.5%) and 10 (17.8%) had progressed. Kaplan-Meier estimates showed a 5-year survival rate of 87.5% and a 5-year progression-free survival of 83%. We assessed HRQoL and functional outcomes in 32 patients. EuroQol 5D-3L showed a mean health status of 82.5%, median Voiding score of the ICIQ-MLTUS was 4 (IQR 1-15), and median IIEF-5 19 (IQR 10.75-25).
OSS of the penis remains a safe and viable option for the treatment of SCC, ensuring a favorable appearance of the penis, preserving urinary and sexual function, with good HRQoL and without comprising oncological safety in selected cases.
描述接受阴茎鳞癌保器官重建手术（OSS）治疗的患者的肿瘤学和功能结局。阴茎癌的治疗选择之一是采用带蒂皮瓣的整形外科 OSS，其目标是在不影响肿瘤控制的情况下，保持生理排尿和性功能。
这是一项多中心研究，报告了 2007 年至 2019 年间，57 例接受 OSS 和带蒂皮瓣整形重建手术治疗的阴茎恶性病变患者的临床病理数据。采用欧洲生命质量五维量表（EuroQoL-5D-3L）评估健康相关生活质量（HRQoL），采用国际下尿路症状咨询问卷-男性下尿路症状模块（ICIQ-MLUTS）评估尿症状，采用国际勃起功能指数（IIEF-5）评估勃起功能。
57 例患者接受了 OSS 重建手术。20 例行龟头再造术，23 例行部分阴茎切除术，14 例行阴茎部分切除术。中位年龄为 55.1 岁（四分位间距[IQR]29-90），中位随访时间为 55.7 个月（3-149）。在数据分析时，6 例患者死于鳞状细胞癌（SCC）（12.5%），10 例（17.8%）进展。Kaplan-Meier 估计显示 5 年生存率为 87.5%，5 年无进展生存率为 83%。我们评估了 32 例患者的 HRQoL 和功能结局。欧洲生命质量五维量表（EuroQoL-5D-3L）显示平均健康状况为 82.5%，国际尿失禁咨询问卷-男性下尿路症状模块（ICIQ-MLUTS）的平均排尿评分中位数为 4（IQR 1-15），国际勃起功能指数（IIEF-5）中位数为 19（IQR 10.75-25）。
对于 SCC 的治疗，阴茎 OSS 仍然是一种安全可行的选择，能够确保阴茎外观良好，保持尿和性功能，同时具有良好的 HRQoL，并且在选定病例中不影响肿瘤安全性。
