无远处转移晚期阴茎癌的手术治疗

Surgical treatment of advanced penile cancer without distant metastasis

目的:探讨无远处转移的晚期阴茎癌的手术疗效及影响预后的因素。方法:分析2007年9月至2015年7月行阴茎切除术及淋巴结清扫术的无远处转移晚期阴茎癌8例患者的临床资料,患者年龄37~67岁,平均51.1岁,术后随访4~60个月,平均19.25个月,分析影响患者预后的因素及手术疗效。结果:术后3例存活至今,另5例死亡,死亡率62.5%,从手术到死亡时间4~13个月,平均9个月。术后无明显并发症,4例大面积缺损患者术后皮瓣均预后良好。结论:无远处转移的晚期阴茎癌患者预后不佳,淋巴结转移是影响预后的重要因素,手术是一种相对有效的治疗手段,皮瓣可以修复肿瘤切除后的大面积皮肤缺损,尚无足够资料证明综合疗法是否有效。

Objective： To investigate the effect of surgery on advanced penile cancer without distant metastasis and the factors influencing the prognosis. Methods： Between September 2007 and July 2015,we treated 8 cases of advanced penile cancer without distant metastasis by penectomy and lymph node dissection. The patients were aged 37- 67（ mean 51. 1） years. We followed up the patients for 4- 60（ mean 19. 25） months postoperatively and analyzed the surgical effects and the factors affecting the prognosis.Results： Three of the patients remained alive while the other 5（ 62. 5%） died at 4- 13（ mean 9） months after surgery. No significant complications were observed and myocutaneous flap repair showed good prognosis in 4 of the patients with large-area skin defect.Conclusion： Surgery is comparatively a valuable option for the treatment of advanced penile cancer without distant metastasis,though with a poor prognosis,and the important factor affecting its prognosis is lymph node metastasis. Flap repair can solve the problem of large-area skin defect after surgery. However,evidence is not yet sufficient to prove the effectiveness of multimodality therapy of this malignancy.