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中欧背景下的阴茎癌概况:临床特征、预后及结局——来自波兰一家三级医疗中心的见解

Penile Cancer Profile in a Central European Context: Clinical Characteristics, Prognosis, and Outcomes-Insights from a Polish Tertiary Medical Center.

作者信息

Czajkowski Mateusz, Falis Michał, Błaczkowska Agata, Rybarczyk Agnieszka, Wierzbicki Piotr M, Gondek Jakub, Matuszewski Marcin, Hakenberg Oliver W

机构信息

Department of Urology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland.

Division of Radiology Informatics and Statistics, Medical University of Gdańsk, Tuwima 15 Street, 80-210 Gdańsk, Poland.

出版信息

Cancers (Basel). 2025 Jun 25;17(13):2140. doi: 10.3390/cancers17132140.

Abstract

Penile cancer is an uncommon malignancy in European and North America countries, accounting for less than 1% of malignant neoplasms. The etiology of penile cancer involves a complex interplay of clinical and behavioral factors, including phimosis, smoking, excess body weight, and HPV infection. The significance of these factors varies according to geographical and socioeconomic contexts. A comprehensive understanding of these interactions is essential for developing targeted prevention strategies and improving outcomes across diverse populations. However, the majority of existing studies originate from South America or Africa; there is a lack of data regarding these associations and prognoses in European populations, particularly in Central Europe, including Poland. : This study aimed to investigate the prevalence of well-established clinical and behavioral characteristics associated with penile cancer and their influence on penile cancer prognosis in a cohort of 153 patients who underwent surgical intervention at a single tertiary medical center in Central Europe. : This retrospective study was conducted from October 2011 to October 2024 at a single tertiary medical center and included 153 patients who underwent surgical treatment for penile cancer during this period. Demographic and histopathological data were collected. A comprehensive, self-administered patient survey was conducted to identify the presence of potentially relevant clinical and lifestyle characteristics. Moreover, the prevalence of human papillomavirus (HPV) in penile cancer specimens was determined using p16 immunohistochemistry. : The median age of the participants in the study was 64 years (range: 30-87). The predominant identified features were phimosis (47.06%), residence in small agglomerations (43.14%), obesity (43.14%), overweight (40.52%), and smoking (38.56%). HPV infection was detected in only 14.38% of the patients. Phimosis was associated with a more locally advanced penile cancer stage (T-stage). The stage of the primary tumor, lymph node involvement, and histopathological grading significantly affected patient survival, with a poorer prognosis observed in more advanced stages and associated with poorly differentiated histopathological features. Among all the examined clinical and lifestyle characteristics, only smoking demonstrated a significant two-fold higher risk of mortality and was associated with a significantly lower overall survival compared to the absence of smoking ( = 0.047). Conversely, human papillomavirus (HPV) infection was associated with a six-fold reduction in the risk of death ( = 0.063). : Phimosis was the most frequently observed clinical characteristic in our cohort study and was correlated with a more advanced penile cancer tumor stage. Smoking was associated with lower rates of patient survival, while HPV-positive patients demonstrated a trend toward lower mortality compared to HPV-negative patients.

摘要

阴茎癌在欧洲和北美国家是一种罕见的恶性肿瘤,占恶性肿瘤的比例不到1%。阴茎癌的病因涉及临床和行为因素的复杂相互作用,包括包茎、吸烟、超重和人乳头瘤病毒(HPV)感染。这些因素的重要性因地理和社会经济背景而异。全面了解这些相互作用对于制定有针对性的预防策略和改善不同人群的治疗结果至关重要。然而,大多数现有研究来自南美洲或非洲;欧洲人群,特别是包括波兰在内的中欧地区,缺乏关于这些关联和预后的数据。本研究旨在调查在中欧一家三级医疗中心接受手术干预的153名患者队列中,与阴茎癌相关的既定临床和行为特征的患病率及其对阴茎癌预后的影响。这项回顾性研究于2011年10月至2024年10月在一家三级医疗中心进行,纳入了在此期间接受阴茎癌手术治疗的153名患者。收集了人口统计学和组织病理学数据。进行了一项全面的、患者自行填写的调查,以确定是否存在潜在相关的临床和生活方式特征。此外,使用p16免疫组织化学方法测定阴茎癌标本中人乳头瘤病毒(HPV)的患病率。研究参与者的中位年龄为64岁(范围:30 - 87岁)。确定的主要特征为包茎(47.06%)、居住在小聚居地(43.14%)、肥胖(43.14%)、超重(40.52%)和吸烟(38.56%)。仅14.38%的患者检测到HPV感染。包茎与阴茎癌更局部晚期阶段(T分期)相关。原发肿瘤的分期、淋巴结受累情况和组织病理学分级显著影响患者生存,在更晚期阶段观察到预后较差,且与组织病理学特征分化差相关。在所有检查的临床和生活方式特征中,只有吸烟显示出显著高出两倍的死亡风险,并且与不吸烟相比,总体生存率显著降低(P = 0.047)。相反,人乳头瘤病毒(HPV)感染与死亡风险降低六倍相关(P = 0.063)。包茎是我们队列研究中最常观察到的临床特征,并且与阴茎癌肿瘤更晚期阶段相关。吸烟与患者生存率较低相关,而HPV阳性患者与HPV阴性患者相比显示出死亡率较低的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4357/12248994/8d58e0132456/cancers-17-02140-g001.jpg

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