Qu Weiling, Tang Qiu
Department of Radiation Oncology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, Zhejiang, China.
Int Urol Nephrol. 2025 Jul 3. doi: 10.1007/s11255-025-04637-5.
Due to the limited number of patients with penile cancer, there is currently no prospective randomized study on patients with penile cancer, especially on patients with distant metastasis of penile cancer. The objective of this study was to develop a nomogram based on a large cohort to predict the probability of distant metastasis in patients with penile squamous cell carcinoma. 1453 patients were included in our study. Univariate and multivariate logistic regression analyses were employed to identify the independent variables, which were used to construct a nomogram. In this nomogram, high grade, high N stage, and primary site surgery (OR 0.354, 95% CI 0.146-0.859) were predictors of distant metastasis in patients with penile squamous cell carcinoma. The area under the curve (AUC) for internal validation of this nomogram was 0.880. Incisional biopsy of regional lymph nodes had been demonstrated to be associated with a poorer survival prognosis in patients with one distant metastatic site. Furthermore, patients with two metastases had a significantly worse survival rate than those with a single metastasis. These findings may prove instrumental in the surgical decision-making process.
由于阴茎癌患者数量有限，目前尚无针对阴茎癌患者的前瞻性随机研究，尤其是针对阴茎癌远处转移患者的研究。本研究的目的是基于一个大型队列开发一种列线图，以预测阴茎鳞状细胞癌患者远处转移的概率。我们的研究纳入了1453例患者。采用单因素和多因素逻辑回归分析来确定独立变量，这些变量用于构建列线图。在该列线图中，高分级、高N分期和原发部位手术（比值比0.354，95%置信区间0.146 - 0.859）是阴茎鳞状细胞癌患者远处转移的预测因素。该列线图内部验证的曲线下面积（AUC）为0.880。区域淋巴结的切开活检已被证明与有一个远处转移部位的患者较差的生存预后相关。此外，有两个转移灶的患者的生存率明显低于有单个转移灶的患者。这些发现可能对手术决策过程有帮助。
