摘要
目的:比较阴茎癌根治术后腹腔镜腹股沟淋巴结清扫术(laparoscopic inguinal lymph node dissection,L-ILND)与开放下腹股沟淋巴结清扫术(open inguinal lymph node dissection,O-ILND)治疗阴茎癌的临床疗效。方法:回顾性分析2008—2020年在华中科技大学同济医学院附属湖北省肿瘤医院泌尿外科诊断为阴茎癌(TNM分期:T_(1-3),N_(0-3),M_(0))并接受L-ILND(41例)或O-ILND(22例)治疗的63例患者的临床疗效。主要研究终点为总生存期,次要研究终点为5年总生存率及5年癌症特异性生存率。对L-ILND组和O-ILND组患者间的不同临床特征进行比较;采用单因素和多因素回归分析法进行伤口并发症的相关因素分析;采用Kaplan-Meier生存分析法进行预后分析;采用COX风险回归分析法进行总生存期预测因子的分析。结果:63例阴茎癌患者中,共有41例患者接受了L-ILND治疗,其余22例患者接受了O-ILND治疗。2组患者基线临床特征的差异无统计学意义(P>0.05);L-ILND与O-ILND 2组患者的中位总生存期(78个月vs 72个月,P=0.844)、5年总生存率(74.5%vs 78.3%,P=0.144)和5年癌症特异性生存率(77.2%vs 71.4%,P=0.228)的差异均无统计学意义;O-ILND组中术后出现伤口并发症的患者人数占比显著高于L-ILND组(74%vs 15%,P=0.012);多因素回归分析结果提示,肿瘤分级[风险比(hazard ratio,HR)=2.774,P=0.021]和淋巴结病理分期(HR=1.482,P=0.024)与患者的预后显著相关。结论:L-ILND与O-ILND的临床疗效相当,而L-ILND的安全性更高,术后伤口并发症发生率更低,因此L-ILND是阴茎癌根治术后ILND更为理想的手术方式。
Objective:To compare the clinical efficacy of laparoscopic inguinal lymph node dissection(L-ILND)and open inguinal lymph node dissection(O-ILND)in the treatment of penile cancer after radical penile cancer surgery.Methods:The clinical outcomes of 63 patients who were diagnosed with penile cancer(TNM staging:T_(1-3),N_(0-3),M_(0))and received L-ILND(41 cases)or O-ILND(22 cases)after radical penile cancer surgery in Department of Urology,Hubei Cancer Hospital,Tongji Medical College,Huazhong University of Science and Technology from 2008 to 2020 were retrospectively studied.The primary endpoint of this study was overall survival,and the secondary endpoints were 5-year overall survival and 5-year cancer-specific survival.The different clinical characteristics were compared between the L-ILND group and O-ILND group.Univariate and multivariate logistic regression analysis was used to study the risk facotrs for postoperative wound complications.Kaplan-Meier method was used for prognosis analysis.COX regression analysis was used to investigate the factors for overall survival prediction.Results:Among the 63 penile cancer patients studied,41 patients received L-ILND and the remaining 22 received O-ILND.There were no statistically significant differences in the baseline characteristics between the two groups of patients.The median overall survival(78 months vs 72 months,P=0.844),5-year overall survival rate(74.5%vs 78.3%,P=0.144),5-year cancer-specific survival rate(77.2%vs 71.4%,P=0.228)showed no obvious difference between L-ILND and O-ILND group.The rate of postoperative wound complications in the O-ILND group was significantly higher than that in the L-ILND group(74%vs 15%,P=0.012).The result of multivariate COX regression analysis showed that tumor grade[hazard ratio(HR)=2.774,P=0.021]and lymph node pathological stage(HR=1.482,P=0.024)were significantly correlated with patients’prognosis.Conclusion:The clinical efficacy of L-ILND and O-ILND is similar,but L-ILND has a higher safety profile and lower incidence of post
作者
邓康俐
崔殿生
魏卓
宋勇波
贾全安
刘三河
黄雷
魏少忠
DENG Kangli;CUI Diansheng;WEI Zhuo;SONG Yongbo;JIA Quan’an;LIU Sanhe;HUANG Lei;WEI Shaozhong(Department of Urology,Hubei Cancer Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430079,Hubei Province,China;Department of Urology,Xiaogan Central Hospital,Xiaogan 432100,Hubei Province,China)
出处
《肿瘤》
CAS
北大核心
2023年第1期16-28,共13页
Tumor
基金
国家自然科学基金(81700669)
国家癌症中心攀登基金(NCC201817B054)
湖北省自然科学基金青年基金(2016CFB217)
武汉市中青年医学骨干人才培养计划(武卫通2019-87号)
关键词
阴茎癌
腹股沟淋巴结清扫
腹腔镜手术
总生存期
预后
Penile cancer
Inguinal lymphadenectomy
Laparoscope surgery
Overall survival
Prognosis
