Ravi R
Department of Genitourinary Surgery, Cancer Institute (WIA), Madras, India.
Jpn J Clin Oncol. 1993 Feb;23(1):53-8.
From 1962 to 1984, 423 patients with invasive penile cancer and negative groin nodes were subjected to prophylactic lymphadenectomies (n113), observations (n258) or inguinal biopsies (n52) in a non-randomised fashion. The numbers of patients with T2, T3 and T4 lesions were similar in the three groups. The overall five-year disease-free survivals were 94, 93 and 85%, respectively. All groin recurrences in the observation group occurred within 18 months of the surgery for the primary tumor. The five-year disease-free survivals of node-positive patients in the lymphadenectomy and observation groups were 100 and 76%, respectively; three patients in the latter group had refused surgical treatment when their adenopathy was mobile. Morbidity from the prophylactic lymphadenectomies included wound breakdown in 61%, wound infection in 18% and lymphedema in 25% of patients. We feel that neither prophylactic lymphadenectomy nor inguinal biopsy are justified in these patients. Close observation of the groin nodal status would be appropriate.
1962年至1984年期间，423例阴茎浸润癌且腹股沟淋巴结阴性的患者以非随机方式接受了预防性淋巴结清扫术（n = 113）、观察（n = 258）或腹股沟活检（n = 52）。三组中T2、T3和T4病变患者的数量相似。总体五年无病生存率分别为94%、93%和85%。观察组所有腹股沟复发均发生在原发肿瘤手术后18个月内。淋巴结清扫组和观察组中淋巴结阳性患者的五年无病生存率分别为100%和76%；后一组中有3例患者在淋巴结可活动时拒绝了手术治疗。预防性淋巴结清扫术的并发症包括61%的患者伤口裂开、18%的患者伤口感染和25%的患者淋巴水肿。我们认为，对于这些患者，预防性淋巴结清扫术和腹股沟活检均不合理。密切观察腹股沟淋巴结状态是合适的。
