Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual so...Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual source of metastatic penile carcinoma. We report a case of metastatic penile carcinoma that originated from the rectum. Symptomatic improvement occurred with palliative radiotherapy.展开更多
目的探讨老年患者行腹股沟淋巴结清扫手术后的并发症及防治对策。方法 14例70岁以上患者在复旦大学附属肿瘤医院施行了腹股沟淋巴结清扫手术。术前详细评估了肿瘤分期及相关并发病的情况,患者根据体质情况进行美国麻醉师协会(American S...目的探讨老年患者行腹股沟淋巴结清扫手术后的并发症及防治对策。方法 14例70岁以上患者在复旦大学附属肿瘤医院施行了腹股沟淋巴结清扫手术。术前详细评估了肿瘤分期及相关并发病的情况,患者根据体质情况进行美国麻醉师协会(American Society of Anesthesiologists,ASA)评分。按ASA评分后6例患者评分I级,7例Ⅱ级,1例Ⅲ级。手术范围为根治性淋巴结清扫的范围,在手术技术上进行了改良。术后并发症按发生的时间、部位和严重程度分为早期和晚期并发症、局部和全身并发症、轻微和严重的并发症。结果本组患者中有9例施行了双侧腹股沟淋巴结清扫术,5例行单侧清扫手术。所有患者的手术均顺利完成,术后早期全身并发症中轻微并发症占7%,严重并发症占14%;术后早期局部并发症中轻微并发症占30%,无严重并发症;术后晚期并发症中轻微并发症占21%,无严重并发症。结论老年患者行腹股沟淋巴结清扫手术是可行的,局部并发症与较年轻的患者类似,但是需要注意全身并发症的监测。展开更多
The present study aimed to investigate the relationship between histopathological subtype and the probability of inguinal lymph node metastasis （ILNM） in patients with penile squamous cell carcinoma （PSCC）. The cl...The present study aimed to investigate the relationship between histopathological subtype and the probability of inguinal lymph node metastasis （ILNM） in patients with penile squamous cell carcinoma （PSCC）. The clinical records of 198 consecutive patients with PSCC were analyzed retrospectively. Primary lesions were reevaluated according to the 2016 World Health Organization （WHO） histopathological classification. We retrieved the clinicopathological factors from the medical records including age, clinical lymph node stage, pathological tumor stage, lymphatic invasion, and nerve invasion. Uni- and multivariate logistic regression analyses were used to explore the risk factors of ILNM. Multivariate analyses identified clinical lymph node stage （P = 0.000）, pathological tumor stage （P = 0.016）, histologic grade （P = 0.000）, and risk group of histological subtypes （P = 0.029） as independent predictors for ILNM. Compared with the low-risk group of PSCC subtypes, the intermediate- （HR： 3.66, 95% CI. 1.30-10.37, P = 0.021） and high-risk groups （HR： 28.74, 95% Ch 2.37-348.54, P = 0.008） were significantly associated with ILNM. In conclusion, the histopathological subtype of the primary lesion is a significant predictor for ILNM in patients with PSCC.展开更多
Using a population-based cancer registry,Thuret et al.developed 3 nomograms for estimating cancerspecific mortality in men with penile squamous cell carcinoma.In the initial cohort,only 23.0% of the patients were trea...Using a population-based cancer registry,Thuret et al.developed 3 nomograms for estimating cancerspecific mortality in men with penile squamous cell carcinoma.In the initial cohort,only 23.0% of the patients were treated with inguinal lymphadenectomy and had pN stage.To generalize the prediction models in clinical practice,we evaluated the performance of the 3 nomograms in a series of penile cancer patients who were treated with definitive surgery.Clinicopathologic information was obtained from 160 M0 penile cancer patients who underwent primary tumor excision and regional lymphadenectomy between 1990 and 2008.The predicted probabilities of cancer-specific mortality were calculated from 3 nomograms that were based on different disease stage definitions and tumor grade.Discrimination,calibration,and clinical usefulness were assessed to compare model performance.The discrimination ability was similar in nomograms using the TNM classification or American Joint Committee on Cancer staging(Harrell's concordance index = 0.817 and 0.832,respectively),whereas it was inferior for the Surveillance,Epidemiology and End Results staging(Harrell's concordance index = 0.728).Better agreement with the observed cancer-specific mortality was shown for the model consisting of TNM classification and tumor grade,which also achieved favorable clinical net benefit,with a threshold probability in the range of 0 to 42%.The nomogram consisting of TNM classification and tumor grading was shown to have better performance for predicting cancer-specific mortality in penile cancer patients who underwent definitive surgery.Our data support the integration of this model in decision-making and trial design.展开更多
文摘Metastatic penile carcinoma is rare and usually originates from genitourinary tumors. The presenting symptoms or signs have been described as nonspecific except for priapism. Rectal adenocarcinoma is a very unusual source of metastatic penile carcinoma. We report a case of metastatic penile carcinoma that originated from the rectum. Symptomatic improvement occurred with palliative radiotherapy.
文摘目的探讨老年患者行腹股沟淋巴结清扫手术后的并发症及防治对策。方法 14例70岁以上患者在复旦大学附属肿瘤医院施行了腹股沟淋巴结清扫手术。术前详细评估了肿瘤分期及相关并发病的情况,患者根据体质情况进行美国麻醉师协会(American Society of Anesthesiologists,ASA)评分。按ASA评分后6例患者评分I级,7例Ⅱ级,1例Ⅲ级。手术范围为根治性淋巴结清扫的范围,在手术技术上进行了改良。术后并发症按发生的时间、部位和严重程度分为早期和晚期并发症、局部和全身并发症、轻微和严重的并发症。结果本组患者中有9例施行了双侧腹股沟淋巴结清扫术,5例行单侧清扫手术。所有患者的手术均顺利完成,术后早期全身并发症中轻微并发症占7%,严重并发症占14%;术后早期局部并发症中轻微并发症占30%,无严重并发症;术后晚期并发症中轻微并发症占21%,无严重并发症。结论老年患者行腹股沟淋巴结清扫手术是可行的,局部并发症与较年轻的患者类似,但是需要注意全身并发症的监测。
基金This study was supported by the Natural Science Foundation of Anhui Province （No. 1608085QH173） and the Research Foundation of Anhui Medical University （No. 2015xkj025）.
文摘The present study aimed to investigate the relationship between histopathological subtype and the probability of inguinal lymph node metastasis （ILNM） in patients with penile squamous cell carcinoma （PSCC）. The clinical records of 198 consecutive patients with PSCC were analyzed retrospectively. Primary lesions were reevaluated according to the 2016 World Health Organization （WHO） histopathological classification. We retrieved the clinicopathological factors from the medical records including age, clinical lymph node stage, pathological tumor stage, lymphatic invasion, and nerve invasion. Uni- and multivariate logistic regression analyses were used to explore the risk factors of ILNM. Multivariate analyses identified clinical lymph node stage （P = 0.000）, pathological tumor stage （P = 0.016）, histologic grade （P = 0.000）, and risk group of histological subtypes （P = 0.029） as independent predictors for ILNM. Compared with the low-risk group of PSCC subtypes, the intermediate- （HR： 3.66, 95% CI. 1.30-10.37, P = 0.021） and high-risk groups （HR： 28.74, 95% Ch 2.37-348.54, P = 0.008） were significantly associated with ILNM. In conclusion, the histopathological subtype of the primary lesion is a significant predictor for ILNM in patients with PSCC.
文摘Using a population-based cancer registry,Thuret et al.developed 3 nomograms for estimating cancerspecific mortality in men with penile squamous cell carcinoma.In the initial cohort,only 23.0% of the patients were treated with inguinal lymphadenectomy and had pN stage.To generalize the prediction models in clinical practice,we evaluated the performance of the 3 nomograms in a series of penile cancer patients who were treated with definitive surgery.Clinicopathologic information was obtained from 160 M0 penile cancer patients who underwent primary tumor excision and regional lymphadenectomy between 1990 and 2008.The predicted probabilities of cancer-specific mortality were calculated from 3 nomograms that were based on different disease stage definitions and tumor grade.Discrimination,calibration,and clinical usefulness were assessed to compare model performance.The discrimination ability was similar in nomograms using the TNM classification or American Joint Committee on Cancer staging(Harrell's concordance index = 0.817 and 0.832,respectively),whereas it was inferior for the Surveillance,Epidemiology and End Results staging(Harrell's concordance index = 0.728).Better agreement with the observed cancer-specific mortality was shown for the model consisting of TNM classification and tumor grade,which also achieved favorable clinical net benefit,with a threshold probability in the range of 0 to 42%.The nomogram consisting of TNM classification and tumor grading was shown to have better performance for predicting cancer-specific mortality in penile cancer patients who underwent definitive surgery.Our data support the integration of this model in decision-making and trial design.
