Fernández Gómez J M, Rábade Rey C J, Pérez García F J, Javier Rodríguez J, Escaf Barmadah S, Alonso Sainz F
Servicio de Urología, Hospital Covadonga, Hospital Central de Asturias, España.
Arch Esp Urol. 1997 Apr;50(3):243-52.
To review our series of epidermoid carcinoma of the penis.
30 cases of epidermoid carcinoma of the penis are reviewed. The clinical features, tumor stage, grade, treatment and outcome are analyzed.
The time to diagnosis ranged from one month to 10 years, mean 10.3 months (1 to 36); therefore the mean diameter of the tumors was significantly greater (1.9 cm) at the time of diagnosis than at the beginning of the lesion. Eighteen patients had tumor superinfection. Twenty-four patients (80%) had low grade carcinoma; 6 had verrucous carcinoma, 6 (16.7%) intermediate and one (3.3%) high grade. Total penectomy with perineal meatus was performed in 5 cases, 23 had a partial penectomy with 2 cm margin and circumcision was done in two cases. Patients with positive lymph nodes at exploration after antibiotic treatment (13 cases) were submitted to lymphadenectomy, which was associated with chemotherapy in 4 patients. The surgical complications were mainly lymphorrhea and edema and infection of the surgical incision after lymphadenectomy. Complications at the site of penile resection were unusual. Only 6 patients have more than 5 years' follow-up (7-14), with only 1 local recurrence. The remaining patients have a mean follow-up of 22 +/- 16 months (6-60). Of these, only one patient had died from penile cancer (previously pT2pN0M0). This patient had lymph node and distant metastases 6 months following penectomy due to invasive local recurrence (pT3pN2pM1). Lymph node recurrence has been detected in three other patients.
Inguinal lymphadenectomy is clearly of therapeutic value in cancer of the penis and performing it early in infiltrating tumors is likely to improve the outcome in these patients.
回顾我们收治的阴茎表皮样癌病例系列。
回顾30例阴茎表皮样癌病例。分析其临床特征、肿瘤分期、分级、治疗方法及预后。
确诊时间为1个月至10年，平均10.3个月（1至36个月）；因此，肿瘤在确诊时的平均直径（1.9厘米）明显大于病变初期。18例患者发生肿瘤继发感染。24例患者（80%）为低级别癌；6例为疣状癌，6例（16.7%）为中级别，1例（3.3%）为高级别。5例行会阴尿道口全阴茎切除术，23例行2厘米切缘的部分阴茎切除术，2例行包皮环切术。抗生素治疗后探查发现淋巴结阳性的患者（13例）接受了淋巴结清扫术，其中4例同时接受了化疗。手术并发症主要为淋巴漏、水肿以及淋巴结清扫术后手术切口感染。阴茎切除部位的并发症不常见。只有6例患者有超过5年的随访（7至14年），仅1例局部复发。其余患者的平均随访时间为22±16个月（6至60个月）。其中，仅1例患者死于阴茎癌（之前为pT2pN0M0）。该患者在阴茎切除术后6个月因局部复发浸润（pT3pN2pM1）出现淋巴结和远处转移。另外3例患者检测到淋巴结复发。
腹股沟淋巴结清扫术对阴茎癌具有明确的治疗价值，对于浸润性肿瘤早期进行该手术可能会改善这些患者的预后。
