男性原发绒癌13例临床分析并文献回顾

Clinical analysis of primary choriocarcinoma in 13 male patients and review of literatures

目的探讨男性原发绒癌的诊断、治疗及预后因素。方法回顾性分析北京协和医院1990年至2012年收治的男性绒癌患者的临床资料，并复习同期文献报道的男性绒癌患者临床资料。结果本院13例患者的中位生存期54个月，包括7个原发部位。所有患者均经手术治疗，12例患者同时加用了联合化疗或放疗。随访至2013年3月，6例患者存活，疾病无复发（随访时间21～138月）。复习文献100例病例，连同我院病例共113例，总的中位生存期10个月，肿瘤最常见的原发部位为睾丸（41／113），大部分伴有转移（80／113）。年龄≤34岁、绒癌合并其他组织成分、联合化疗的患者中位生存期较长。结论男性原发绒癌预后较女性妊娠绒癌明显差，经积极的化疗可延长生存期，年轻（≤34岁）、肿瘤合并其他组织成分者，预后相对偏好。

Objective： To analyze the management and prognosis of primary choriocarcinoma in male patients. Methods. The clinical records of primary choriocarcinoma in male patients who were treated in Peking Union Medical College Hospital （PUMCH）since 1990 were analyzed retrospectively. The literatures concerning the clinical conditions were reviewed. Results. Median survival interval was 54 months in PUMCH patients. All patients were treated with operation,and twelve of them were treated with combined chemotherapy. Up to March 2013, six patients were still alive, and the follow-up time was 21-138 months. According to the data of our 13 patients and 100 literature patients,median survival interval Was 10 months（ranges, 6.4-13.6 months）. Most primary sites were testeS（36.2 %）and most patients（70. 9 %）had metastatic lesions at the time of diagnosis. On the basis of univariate and multivariate analysis, patients age 34 years old, presence of other ingredients histologically, and combined chemotherapy were significantly associated with a long median survival interval. Conclusions： Primary choriocarcinomas in male is an extremely rare disease,and the prognosis is much worse than that of gestational choriocarcinomas. The patients age 34 years old, presence of other ingredient histologically, and combined chemotherapy are strong indicators of better prognosis in malepatients with primary choriocarcinomas.