Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
BJU Int. 2024 May;133(5):596-603. doi: 10.1111/bju.16306. Epub 2024 Feb 25.
To evaluate penile squamous cell carcinoma (PSCC) incidence and centralisation trends in the Netherlands over the past three decades, as well as the effect of centralisation of PSCC care on survival.
In the Netherlands PSCC care is largely centralised in one national centre of expertise (Netherlands Cancer Institute [NCI], Amsterdam). For this study, the Netherlands Cancer Registry, an independent nationwide cancer registry, provided per-patient data on age, clinical and pathological tumour staging, follow-up, and vital status. Patients with treatment at the NCI were identified and compared to patients who were treated at all other centres. The age-standardised incidence rate was calculated with the European Standard Population. The probability of death due to PSCC was estimated using the relative survival. Multivariable Cox regression analysis was performed to evaluate predictors of survival.
A total of 3160 patients were diagnosed with PSCC between 1990 and 2020, showing a rising incidence (P < 0.001). Annual caseload increased at the NCI (1% in 1990, 65% in 2020) and decreased at other (regional) centres (99% to 35%). Despite a relatively high percentage of patients with T2-4 (64%) and N+ (33%) at the NCI, the 5-year relative survival was higher (86%, 95% confidence interval [CI] 82-91%) compared to regional centres (76%, 95% CI 73-80%, P < 0.001). Patients with a pathological T2 tumour were treated with glans-sparing treatment more often at the reference centre than at the regional centres (16% vs 5.0%, P < 0.001). After adjusting for age, histological grading, T-stage, presence of lymph node involvement and year of diagnosis, treatment at regional centres remained a predictor for worse survival (hazard ratio 1.22, 95% CI 1.05-1.39; P = 0.006).
The incidence of PSCC in the Netherlands has been gradually increasing over the past three decades, with a noticeable trend towards centralisation of PSCC care and improved relative survival rate.
评估过去三十年来荷兰阴茎鳞状细胞癌 (PSCC) 的发病率和集中趋势，以及 PSCC 治疗集中化对生存率的影响。
在荷兰，PSCC 治疗主要集中在一个国家专门中心（荷兰癌症研究所 [NCI]，阿姆斯特丹）。在这项研究中，独立的全国癌症登记处荷兰癌症登记处提供了每位患者的年龄、临床和病理肿瘤分期、随访和生存状况数据。确定在 NCI 接受治疗的患者，并将其与在所有其他中心接受治疗的患者进行比较。使用欧洲标准人口计算年龄标准化发病率。使用相对生存率估计 PSCC 死亡概率。进行多变量 Cox 回归分析以评估生存的预测因素。
1990 年至 2020 年间，共有 3160 名患者被诊断患有 PSCC，发病率呈上升趋势（P<0.001）。NCI 的年病例量增加（1990 年为 1%，2020 年为 65%），而其他（区域）中心的病例量减少（99%至 35%）。尽管 NCI 有相对较高比例的 T2-4（64%）和 N+（33%）患者，但 5 年相对生存率更高（86%，95%置信区间 [CI] 82-91%）与区域中心（76%，95%CI 73-80%，P<0.001）。在参考中心，病理 T2 肿瘤患者接受龟头保留治疗的比例高于区域中心（16%比 5.0%，P<0.001）。在调整年龄、组织学分级、T 期、淋巴结受累和诊断年份后，在区域中心接受治疗仍然是生存率较差的预测因素（风险比 1.22，95%CI 1.05-1.39；P=0.006）。
过去三十年来，荷兰 PSCC 的发病率逐渐上升，PSCC 治疗集中化趋势明显，相对生存率提高。
