cN0期阴茎癌患者腹股沟淋巴结清扫的研究进展

Research progress on inguinal lymph node dissection in patients with cN0 penile cancer

阴茎癌是一种发病率较低的恶性肿瘤,主要通过淋巴结进行转移,并且淋巴结的转移情况是肿瘤预后的重要因素。对于临床上无触及或可见的增大的腹股沟淋巴结的cN0期阴茎癌患者,如何权衡腹股沟淋巴结清扫带来的手术获益与伤害,是临床上一项重要的挑战。cN0期患者在原发灶切除后选择主动监测或是淋巴结清扫需要经过筛选,其中高危的患者可能需要更积极的治疗。早期进行腹股沟淋巴结清扫可能带来生存获益。改良的腹股沟淋巴结清扫、动态显像前哨淋巴结活检等手段会减少传统腹股沟淋巴结清扫的创伤,但对cN0期患者行放疗的证据不足。

Penile cancer is a kind of malignant tumor with low incidence rate,which mainly metastasizes through lymph nodes,and lymph node metastasis is an important factor for the prognosis.For cN0 penile cancer patients with clinically unexposed or visible enlarged inguinal lymph nodes,it is a clinically important challenge to balance the benefits and injuries of inguinal lymph node dissection.Patients in cN0 stage who choose active monitoring or lymph node dissection after excision of the primary lesion need to be screened,and those with intermediate or high risk may require more aggressive treatment.Early inguinal lymph node dissection may bring survival benefits.Modified inguinal lymph node dissection and dynamic sentinel lymph node biopsy can reduce the trauma of traditional inguinal lymph node dissection,but there is insufficient evidence for radiotherapy in patients with cN0.