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目的探讨阴茎转移癌的临床特点、诊治方法及预后。方法回顾性分析18例阴茎转移癌患者的临床及随访资料并复习相关文献。18例患者原发肿瘤包括膀胱癌8例,前列腺癌4例,直肠癌2例,结肠癌、肾癌、食管癌和肺癌各1例。其中9例患者接受了阴茎切除+静脉化疗,5例患者仅接受静脉化疗未行阴茎切除术,2例患者仅接受了阴茎局部放疗,1例肾癌患者仅接受了索拉菲尼靶向治疗。结果本组18例患者中,从确诊原发肿瘤至出现阴茎转移时间为1~100月,平均(18.7±1.9)月。从确诊阴茎转移至患者死亡时间为4~23月,平均(10.2±1.7)月。所有18例患者均死于出现阴茎转移2年内。结论阴茎转移癌是一种罕见且预后较差的疾病,即使进行治疗,多数患者仍死于确诊阴茎转移1年内。逆行性静脉途经是发生阴茎转移的主要机制。阴茎切除仅限于缓解局部症状而不应常规应用。
Objective To investigate the clinical features, diagnosis and treatment of penile cancer and its prognosis. Methods Retrospective analysis of 18 cases of penile cancer patients with clinical and follow-up data and review the relevant literature. Eighteen patients had primary tumors including 8 cases of bladder cancer, 4 cases of prostate cancer, 2 cases of rectal cancer, 1 case of colon cancer, renal cancer, esophageal cancer and lung cancer. Nine of the patients underwent pencision plus venous chemotherapy, five patients received only venous chemotherapy without a penectomy, two received only penile local radiotherapy, and one patient with renal cancer received only sorafenib targeted therapy . Results 18 cases of patients in this group, from the diagnosis of primary tumor to penis metastasis from 1 to 100 months, an average of (18.7 ± 1.9) months. The time from the diagnosis of penile metastasis to death was 4 to 23 months, with an average of (10.2 ± 1.7) months. All 18 patients died of penile metastases within 2 years. Conclusions Penile metastatic cancer is a rare and poorly prognosed disease and most patients die within 1 year of confirmed penile metastasis even after treatment. Retrograde venous approach is the main mechanism of penile metastasis. Penile resection is limited to relieve local symptoms and should not be routinely used.