阴茎癌淋巴结转移的治疗

Treatment of Penile Carcinoma with Lymph Node Metastasis

目的 探讨阴茎癌淋巴结转移的治疗方法。方法 回顾性分析 1970年～ 1993年收治的 5 3例阴茎癌淋巴结转移病例的临床资料。结果 阴茎癌伴腹股沟淋巴结转移 5 3例 ,占同期收治阴茎癌病例的 3 9.9% ( 5 3 /13 3 )。腹股沟淋巴结转移 5 3例中 ,2 2例为阴茎原发癌手术时发现 ,3 1例为阴茎癌术后随访中发现。在随访发现的 3 1例中 ,1年内转移者 2 3例 ,占 74.2 % ,中位转移时间为 7个月。治疗采用腹股沟淋巴结切除联合放疗者 ,1、2、5年生存率分别为 60 .0 % ,47.5 %和 3 7.5 % ,而单纯放疗者 1、2、5年分别为 3 8.5 % ,7.7%和 7.7% ,副作用均少见。结论 对阴茎癌腹股沟淋巴结转移病人采用腹股沟淋巴结切除联合放疗是 1种有效的治疗手段 ,对N3 期病例应进一步寻找有效的综合治疗手段 ,以提高生存率。

Objective To discuss the management of penile carcinoma with lymph node metastasis.Methods Retrospective analysis of the clinical data was made for 53 patients with lymph node metastasis of penis carcinoma who were admitted in our hospital from 1970 to 1993.Results There were 53 cases of penis carcinoma with groin lymph node metastasis,which accounted for 39.9% of the total cases of penis carcinoma admitted in the same period.Of the 53 patients,22 received enlarged lymph nodes resection when the primary penile lesion was managed,and other 31 developed lymph node metastasis during follow up.Of the 31 cases,the median duration from the management of the primary disease to recurrence was 7 months,74.2%(23/31) patients developed lymph node metastasis within 1 year of the management of the primary disease.The 1,2,5 year survival rate is 60.0%,47.5% and 37.5% respectively for patients received lymph node resection combined with local irradiation,and 38.5%,7.7% and 7.7% for patients received simple local irradiation.Conclusion The groin lymph node resection combined with irradiation is an effective treatment for penile carcinoma with lymph node metastasis.To improve the survival rate active comprehensive treatment,especial for stage N 3,is prospective.