Lubke W L, Thompson I M
Department of Urologic Surgery, Wilford Hall USAF Medical Center, Brooke Army Medical Center, San Antonio, TX 78236.
Semin Urol. 1993 May;11(2):80-4.
The battle for the control of squamous cell carcinoma of the penis is either won or lost at the level of the inguinal lymph nodes. Few patients die of distant metastasis without prior development of ilioinguinal nodal disease. If death or recurrence does occur, it does so typically within 2 years. In clinical stage T2-T4, N0 disease, there is a high risk of nodal involvement. In those patients with positive nodes, lymphadenectomy can be curative. It is apparent that forms of therapy other than a surgical approach are distinctly inferior. Awaiting the development of nodal metastasis carries the risk of a significantly lower survival time. Unfortunately, highly sensitive and specific forms of preoperative staging do not exist. With current techniques, ILND can be accomplished with minimal morbidity. For these reasons, it is recommended that all patients with clinical T2-T4, N0 squamous cell carcinoma of the penis undergo immediate inguinal lymphadenectomy.
阴茎鳞状细胞癌的控制之战在腹股沟淋巴结层面要么成功，要么失败。很少有患者在没有先出现髂腹股沟淋巴结疾病的情况下死于远处转移。如果确实发生死亡或复发，通常会在2年内出现。在临床分期为T2 - T4、N0疾病时，淋巴结受累风险很高。对于那些淋巴结阳性的患者，淋巴结清扫术可能治愈。显然，非手术方法的治疗形式明显较差。等待淋巴结转移的出现会带来生存时间显著缩短的风险。不幸的是，不存在高度敏感和特异的术前分期方法。以目前的技术，腹股沟淋巴结清扫术（ILND）可以以最小的发病率完成。基于这些原因，建议所有临床分期为T2 - T4、N0的阴茎鳞状细胞癌患者立即进行腹股沟淋巴结清扫术。
