-
摘要: 目的:分析影响阴茎癌患者预后的危险因素。方法:回顾性分析SEER数据库中2004~2009年诊断为阴茎癌的1 090例患者的临床资料,用Kaplan-Meier生存分析法计算出总体死亡率及肿瘤特异性死亡率,对随访数据进行单因素及Cox多因素回归分析,分析因素包括患者年龄、种族、婚姻状况、原发部位、TNM分期、组织病理学分级。采用Logistic回归模型分析影响阴茎癌区域淋巴结转移的相关因素。结果:阴茎癌患者的5年总体死亡率为51.2%,5年肿瘤特异性死亡率为24.5%。Cox多因素回归分析得出区域淋巴结转移及远处转移是影响阴茎癌预后的独立影响因素。Logistic回归分析显示组织病理学分级是影响阴茎癌区域淋巴结转移的重要因素。结论:区域淋巴结转移及远处转移是影响阴茎癌预后的独立影响因素,组织病理分级通过影响阴茎癌区域淋巴结转移而影响患者预后。Abstract: Objective: To study the independent prognostic factors for penile neoplasm.Method: The clinical data of a cohort of 1 090 patients was collected from 2004 to 2009 based on Epidemiology and End Results (SEER) database. Overall death rates and cancer-specific modality rates were calculated by Kaplan-Meier method. Univariable analysis and Cox regression model was used to analyze the relationship between the influencing factors and the prognosis. The relevant factors included age, race, marital status, primary site, TNM stage and tumor grade. Logistic regression was used to analyze the prognostic factors of regional lymph node metastasis.Result: Five-year overall death rates and five-year cancer-specific modality rates were 51.2% and 24.5% respectively. Cox regression model showed that the independent predictive factors were regional lymph node metastasis and remote metastasis. High tumor grade was regarded as a prognostic factor of regional lymph node metastasis.Conclusion: Regional lymph node metastasis and remote metastasis have certain impacts on the prognosis of penile cancer. High tumor grade implies the inclination of regional lymph node metastasis.
-
Key words:
- penile neoplasm /
- prognosis /
- regional lymph node metastasis
-
-
[1] Ficarra V, Zattoni F, Cunico S C, et al. Lymphatic and vascular embolizations are independent predictive variables of inguinal lymph node involvement in patients with squamous cell carcinoma of the penis:Gruppo Uro-Oncologico del Nord Est (Northeast Uro-Oncological Group) Penile Cancer data base data[J]. Cancer, 2005, 103(12):2507-2516.
[2] Kattan M W, Ficarra V, Artibani W, et al., Nomogram predictive of cancer specific survival in patients undergoing partial or total amputation for squamous cell carcinoma of the penis[J]. J Urol, 2006, 175(6):2103-2108; discussion 2108.
[3] Barnholtz-Sloan J S, Maldonado J L, Pow-sang J, et al. Incidence trends in primary malignant penile cancer[J]. Urol Oncol, 2007, 25(5):361-367.
[4] Pukkala E, Weiderpass E. Weiderpass, Socio-economic differences in incidence rates of cancers of the male genital organs in Finland, 1971-95[J]. Int J Cancer, 2002, 102(6):643-648.
[5] Cabanas R M. Anatomy and biopsy of sentinel lymph nodes[J]. Urol Clin North Am, 1992, 19(2):267-276.
[6] Burgers J K, Badalament R A, Drago J R. Penile cancer. Clinical presentation, diagnosis, and staging[J]. Urol Clin North Am, 1992, 19(2):247-256.
[7] Graafland N M, van Boven H H, van Werkhoven E, et al. Prognostic significance of extranodal extension in patients with pathological node positive penile carcinoma[J]. J Urol, 2010, 184(4):1347-1353.
[8] Pagliaro L C, Crook J. Multimodality therapy in penile cancer:when and which treatments[J]? World J Urol, 2009, 27(2):221-225.
[9] Pandey D, Mahajan V, Kannan R R. Prognostic factors in node-positive carcinoma of the penis[J]. J Surg Oncol, 2006, 93(2):133-138.
[10] Alkatout I, Naumann C M, Hedderich J, et al. Squamous cell carcinoma of the penis:predicting nodal metastases by histologic grade, pattern of invasion and clinical examination[J]. Urol Oncol, 2011, 29(6):774-781.
[11] Ficarra V, Akduman B, Bouchot O, et al. Prognostic factors in penile cancer[J]. Urology, 2010, 76(2 Suppl 1):S66-73.
[12] Velazquez E F, Ayala G, Liu H, et al. Histologic grade and perineural invasion are more important than tumor thickness as predictor of nodal metastasis in penile squamous cell carcinoma invading 5 to 10 mm[J]. Am J Surg Pathol, 2008, 32(7):974-979.
-
计量
- 文章访问数: 87
- PDF下载数: 98
- 施引文献: 0