62例阴茎鳞状细胞癌治疗的临床分析

目的:提高阴茎鳞状细胞癌的治疗水平,寻求鳞状细胞癌合理有效的治疗方法。方法:回顾分析62例病理活检证实阴茎鳞状细胞癌治疗的临床资料。结果:除8例拒绝手术治疗外,其余54例均行手术治疗。45例行阴茎部分切除术,9例行阴茎全切加会阴部尿道造口术治疗,腹股沟淋巴结活检术31例,腹股沟淋巴结病理阳性9例,总活检阳性率为29.0%,行腹股沟淋巴结清扫术。5例行阴茎部分切除者3年内复发,再行阴茎全切除并尿道会阴部造口术及髂腹股沟淋巴清扫术。高分化鳞癌43例,中分化鳞癌7例,低分化鳞癌4例;9例术前淋巴结活检有癌转移,腹股沟淋巴结清扫均有转移,盆腔淋巴结转移4例,淋巴结清扫发现转移2例。按照Jackson分期:I期29例;II期13例;III期8例;V期4例。本组62例患者中44例获定期随访2-7年,随访率70.9%。3年、5年生存率分别为90.9%、75%。非手术治疗5年生存率仅为50%。结论:外科手术治疗是目前治疗阴茎鳞状细胞癌的有效方法,淋巴结清扫根据临床分级具体处理,手术联合术后化、放疗是否可减少复发及提高生存率,还需进一步研究。

Diagnosis and treatment of sixty- two penile squamous cell carcinoma

Objective: To study the rational and effective treatments for penile squamous cell carcinoma(PSCC).Methods: Retrospectively analyzed the clinical data of 62 cases of pathologically confirmed PSCC,focusing on the treatment methods.Results: Fifty four of the 62 patients were treated by surgery,of whom 45 underwent limited resection of the tumor or partial amputation of the penis,and the other 9 received total penis amputation plus perineal urethrostomy.31 underwent lymph nodes biopsy,9 were positive and moved to clearance of lymph nodes.5 of the patients whom underwent limited resection of the tumor or partial amputation of the penis experienced local recurrence and thus underwent total penis amputation plus perineal urethrostomy and clearance of lymph nodes.Based on Jackson Staging,29 of the 54 cases were in stage I,18 stage II,11 stage III,and 4 stage V.43 cases were high differentiated squamous cell carcinoma,7 cases were middle differentiated squamous cell carcinoma and 4 cases were poor differentiated squamous cell carcinoma.The 2-7 years follow-up rate was 70.9%.The 3 and 5-year survival rates were 90.9%,75%,respectively.The 5-year survival rate for non-surgery treatment was only 50%.Conclusion:Surgery is an effective method for PSCC,but whether radio and chemotherapy can reduce the recurrence of PSCC and improve the survival of the patients remains to be further studied.