Kilani Elmasri S, Martín Castillo J, Fernández Rojo F, Gómez Cisneros S, Parra Montaner L, García Alonso J
Servicio de Anatomía Patológica, Hospital Camino de Santiago, Ponferrada, León, España.
Arch Esp Urol. 1995 May;48(4):347-52.
We reviewed our series of epidermoid penile cancer to determine the predictive index of lymph node invasion and the incidence of phimosis in these patients.
We reviewed the records of 11 patients with epidermoid cancer of the penis. Six patients had been evaluated according to a protocol that included preoperative biopsy of the lesion, penile and abdominal ultrasound evaluation, CT and diagnostic lymphadenectomy for those cases suspected as having lymph node invasion. The predictive index (PI) was determined in relation to the grading of cell differentiation (G) and tumor stage (S) [PI = G+T] and the incidence of phimosis was sought during the interview.
Lymph node invasion was confirmed in 2 patients with PI = 6 and in 1 patient with PI = 5. Diagnostic lymphadenectomy showed no evidence of lymphatic spread in 1 patient with PI = 3 and in another patient with PI = 4. The remaining 6 patients with PI < 2 did not undergo lymphadenectomy. Phimosis was associated in 73% of the cases.
PI is a reliable index for lymph node invasion. Patients with PI < 4 do not require therapeutic lymphadenectomy. Phimosis should be operated early in childhood.
我们回顾了一系列阴茎表皮样癌病例,以确定淋巴结转移的预测指标以及这些患者中包茎的发生率。
我们回顾了11例阴茎表皮样癌患者的病历。6例患者按照一项方案进行了评估,该方案包括病变的术前活检、阴茎和腹部超声评估、对疑似有淋巴结转移的病例进行CT检查和诊断性淋巴结切除术。根据细胞分化分级(G)和肿瘤分期(S)确定预测指标(PI)[PI = G+T],并在访谈中了解包茎的发生率。
2例PI = 6的患者和1例PI = 5的患者被证实有淋巴结转移。诊断性淋巴结切除术显示,1例PI = 3的患者和另1例PI = 4的患者没有淋巴转移的证据。其余6例PI < 2的患者未进行淋巴结切除术。73%的病例伴有包茎。
PI是淋巴结转移的可靠指标。PI < 4的患者不需要进行治疗性淋巴结切除术。包茎应在儿童期早期进行手术。