影响阴茎癌患者预后的危险因素分析

Analysis of prognostic factors for penile cancer

目的：分析影响阴茎癌患者预后的危险因素。方法：回顾性分析SEER数据库中2004～2009年诊断为阴茎癌的1090例患者的临床资料，用Kaplan—Meier生存分析法计算出总体死亡率及肿瘤特异性死亡率，对随访数据进行单因素及Cox多因素回归分析，分析因素包括患者年龄、种族、婚姻状况、原发部位、TNM分期、组织病理学分级。采用Logistic回归模型分析影响阴茎癌区域淋巴结转移的相关因素。结果：阴茎癌患者的5年总体死亡率为51．2％，5年肿瘤特异性死亡率为24．5％。Cox多因素回归分析得出区域淋巴结转移及远处转移是影响阴茎癌预后的独立影响因素。Logistic回归分析显示组织病理学分级是影响阴茎癌区域淋巴结转移的重要因素。结论：区域淋巴结转移及远处转移是影响阴茎癌预后的独立影响因素，组织病理分级通过影响阴茎癌区域淋巴结转移而影响患者预后。

Objective.. To study the independent prognostic factors for penile neoplasm. Method.. The clinical da- ta of a cohort of 1 090 patients was collected from 2004 to 2009 based on Epidemiology and End Results （SEER） database. Overall death rates and cancer-specific modality rates were calculated by Kaplan-Meier method. Univari- able analysis and Cox regression model was used to analyze the relationship between the influencing factors and the prognosis. The relevant factors included age, race, marital status, primary site, TNM stage and tumor grade. Logistic regression was used to analyze the prognostic factors of regional lymph node metastasis. Result.. Five-year overall death rates and five-year cancer-specific modality rates were 51.2% and 24.5% respectively. Cox regres- sion model showed that the independent predictive factors were regional lymph node metastasis and remote metas- tasis. High tumor grade was regarded as a prognostic factor of regional lymph node metastasis. Conclusion： Regional lymph node metastasis and remote metastasis have certain impacts on the prognosis of penile cancer. High tumor grade implies the inclination of regional lymph node metastasis.