阴茎癌的外科治疗——附82例分析

Surgical Treatment of Penile Cancer——Analysis of 82 Patients

从1959～1984年共手术治疗阴茎癌82例。阴茎部分切除13例,阴茎全切除36例,阴茎全切除加腹股沟淋巴结清除33例,总的5年生存率为71.9％。阴茎癌的发生与包茎、包皮过长以及缺乏良好的个人卫生习惯有密切关系。如果病变限于阴茎头,阴茎部分切除足以获得无瘤边缘,当肿瘤侵犯阴茎体时,应行阴茎全切除,建议对腹股沟淋巴结肿大者常规进行活检,如有转移应完成淋巴结清除。原发癌的范围、腹股沟淋巴结转移与否、首次治疗是否适宜是影响预后的重要因素。

From 1959 to 1984, 82 cases of carcinoma of the penis were treated by surgery in our hospital. 13 of them were treated by partial penectomy, 36 by total penectomy and 33 by total penectomy plus inguinal lymphatic dissection. The overall 5-years survival rate was 71. 9%. The study showed that in- cidence of the penile cancer is closely related to phimosis, redundant prepuce and neglect of personal hygiene. It has been demonstrated that partial penectomy is sufficient for obtaining tumor-free margin in patients with the lesion limited at the glans and total penectomy is indicated if the tumor involves the corpora. Routine lymph node biopsy is proposed when adenopathy is present. Inguinal lymphatic dis- section should be performed only if tumor is present in the biopsy. The extent of primary lesion, pres- ence or absence of inguinal lymph node metastasis and proper initial treatment have a great influence on the prognosis of the cancer.