女性原发性尿道癌17例报告

Analysis and literature review of 17 cases of female primary urethral carcinoma

本文回顾性分析云南省肿瘤医院2009—2020年诊治的17例尿道癌患者的临床资料,探讨女性原发性尿道癌的临床特点、诊疗及预后。17例女性原发性尿道癌患者平均年龄57岁;常见临床表现为尿道外口肿物、肉眼血尿、排尿困难;病理类型有腺癌、鳞癌、尿路上皮癌以及其他罕见病理组织类型;17例患者中有16例患者行手术,其中7例患者术后行辅助化疗,1例患者接受辅助放疗。随访时间6~122个月,其中3例患者死亡,6例患者目前仍存活,8例患者失访;经Kaplan-Meier生存分析显示,平均生存时间为78个月,由于随访人数较少,仅计算出23个月生存率为58.3%,中位无进展生存期(progression-free survival,PFS)为25个月。女性原发性尿道癌十分罕见,对于尿道远端局部肿瘤建议确保手术切缘阴性的情况下,行保留尿道的手术或行局部放射治疗替代尿道手术;对于局部晚期患者提倡多元模式治疗,以手术治疗为主选择性辅予放化疗治疗的综合治疗方案。

This paper retrospectively analyzed the clinical data of 17 female patients with urethral cancer treated in Yunnan Cancer Hospital from 2009 to 2020,and discussed the clinical characteristics,diagnosis,treatment and prognosis of female primary urethral cancer.These patients’average age was 57 years old.The common clinical manifestations were external orifice mass,gross hematuria and dysuria.The pathological types include adenocarcinoma,squamous cell carcinoma,urothelial carcinoma and other rare pathological tissue types.Of the 17 patients,16 underwent surgery,of which 7 received adjuvant chemotherapy and 1 received adjuvant radiotherapy.The follow-up time ranged from 6 to 122 months,of which 3 patients died,6 patients were still alive,and 8 patients were lost to follow-up.Kaplan-Meier survival analysis showed that the average survival time was 78 months.Due to the small number of follow-up,only the 23 month survival rate was calculated to be 58.3%,and the median progression free survival(PFS)was 25 months.Primary urethral cancer in women is very rare.It is recommended to perform urethra sparing surgery or local radiotherapy instead of urethra surgery if the surgical margin is negative.For locally advanced patients,we advocate a comprehensive treatment scheme of multi-mode treatment,surgery as the main treatment combined with selective adjuvant radiotherapy and chemotherapy.