来自单一三级转诊中心的阴茎肉瘤样鳞状细胞癌的治疗结果：一项匹配队列研究。

Outcomes of penile sarcomatoid squamous cell carcinoma from a single tertiary referral centre: a matched cohort study.

作者信息

Pang Karl H, Girling Benedict, Osinibi Elizabeth, Sawhney Paramvir, Haider Aiman, Freeman Alex, Hadway Paul, Nigam Raj, Rees Rowland, Mitra Anita, Muneer Asif, Alifrangis Constantine, Alnajjar Hussain M

机构信息

Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK.

Division of Surgery and Interventional Science, University College London, London, UK.

出版信息

BJU Int. 2023 Sep;132(3):337-342. doi: 10.1111/bju.16044. Epub 2023 Jun 1.

DOI:10.1111/bju.16044

PMID:37169730

Abstract

OBJECTIVE

To report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC).

PATIENTS AND METHODS

A retrospective analysis of men with penile sSCC diagnosed between January 2010 and January 2020 in a single centre was conducted. Disease-specific (DSS), recurrence-free (RFS) and metastasis-free (MFS) survival were evaluated. Outcomes were compared with a non-sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan-Meier plots were used to estimate survival outcomes.

RESULTS

In all, 1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (interquartile range) age and follow-up was 70 (57-81) years and 16 (7-44) months, respectively. Operations performed included: circumcision, one (2.6%); wide local excision, four (10.5%); glansectomy, 11 (29%); partial penectomy, 10 (26%); subtotal/total penectomy, 12 (32%). The Kaplan-Meier estimated 12-, 24- and 36-month DSS was 62% (vs non-sarcomatoid, 67%), 43% (vs non-sarcomatoid, 67%) and 36% (vs non-sarcomatoid, 67%), respectively (P = 0.03). The Kaplan-Meier estimated 12- and 24-month RFS was 47% (vs non-sarcomatoid, 60%) and 28% (vs non-sarcomatoid, 55%), respectively (P = 0.01). The MFS was 52% (vs non-sarcomatoid, 62%) at 12 months and 37% (vs non-sarcomatoid, 57%) at 24 months (P = 0.04).

CONCLUSIONS

Sarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.

摘要

目的

报告阴茎肉瘤样鳞状细胞癌（sSCC）男性患者的肿瘤生存结局。

患者与方法

对2010年1月至2020年1月在单一中心诊断为阴茎sSCC的男性患者进行回顾性分析。评估疾病特异性（DSS）、无复发生存率（RFS）和无转移生存率（MFS）。将结果与年龄、手术类型和肿瘤分期相匹配的非肉瘤样阴茎鳞状细胞癌队列进行比较。采用Kaplan-Meier曲线评估生存结局。

结果

在研究期间，共有1286名男性被诊断为阴茎鳞状细胞癌，其中38名（3%）为sSCC。年龄中位数（四分位间距）和随访时间分别为70（57 - 81）岁和16（7 - 44）个月。实施的手术包括：包皮环切术1例（2.6%）；广泛局部切除术4例（10.5%）；龟头切除术11例（29%）；部分阴茎切除术10例（26%）；次全/全阴茎切除术12例（32%）。Kaplan-Meier评估的12个月、24个月和36个月DSS分别为62%（非肉瘤样为67%）、43%（非肉瘤样为67%）和36%（非肉瘤样为67%）（P = 0.03）。Kaplan-Meier评估的12个月和24个月RFS分别为47%（非肉瘤样为60%）和28%（非肉瘤样为55%）（P = 0.01）。12个月时MFS为52%（非肉瘤样为62%），24个月时为37%（非肉瘤样为57%）（P = 0.04）。