The clinicopathological features and prognosis of 362 patients with penile carcinoma
Objective To investigate the clinicopathological features and prognosis of patients with penile cancer.Methods The clinical data of 362 patients with penile cancer who underwent surgery in Fudan University Shanghai Cancer Center from January 2005 to December 2020 were retrospectively analyzed.The mean age was(57.0±0.7)years.According to the clinical N stage classification,239 patients were in N0 stage,57 patients in N,stage,37 patients in N2 stage,and 29 patients in N3 stage.All these patients had no metastasis.Based on tumor size and location,50 patients underwent extended circumcision,283 patients underwent partial penectomy,and 29 patients underwent total penectomy.One hundred and eighty-three patients underwent inguinal lymphadenectomy and 47 patients underwent pelvic lymphadenectomy.Tumor pathology,tumor size,HPV subtype,postoperative pathological stage,overall survival(OS)and prognosis were analyzed.The Kaplan-Meier analysis and multivariate Cox regression analysis were used to analyse the factors which could affect the survival of patients.5-year OS rate of these patients were also calculated.Results In the pathological T classification,137 cases were in T1a stage,24 cases in T1b stage,51 cases in T2 stage,136 cases in T3 stage,and 14 cases in T4 stage.In the pathological N classification,235 cases were in N0 stage,54 cases in N,stage,31 cases in N2 stage and 42 cases in N3 stage.The most common tumor type was squamous cell carcinoma(300 cases,83％),followed by verrucous carcinoma(40 cases,11％),sarcomatoid carcinoma(7 cases),carcinoma in situ(6 cases),basal-like carcinoma(6 cases),and adenosquamous carcinoma(3 cases).The most common tumor grade was mild(160 cases,44％),followed by moderate differentiation(130 cases,36％),poor differentiation(46 cases,13％),and unclear differentiation(26 cases).The tumor sizes were＜3 cm in 135 patients and ≥ 3 cm in 142 patients.The tumor size was unclear in 85 patients.173 cases(48％)were HPV positive and 189 cases(52％)were HPV negative.The Kaplan-Meier analysis showed the 5-year OS rate of HPV-positive group was higher than that of HPV-negative group(79％vs.72％)but no significant difference was found(P=0.09).The 5-year OS rate of patients whose tumor≥3 cm(69％)was lower than those tumor＜3 cm(85％)and significant difference could be found(P=0.02).The 5-year OS rate of wild and moderate and poor grade were 85％,70％and 58％,and significant difference could be found in the three groups(P＜0.01).The 5-year OS rates of patients with stage T1a,T1b,T2,T3and T4 were 90％,67％,71％,68％and 37％respectively(P＜0.01).The 5-year OS rates of patients with stage N0,N1,N2,and N3 were 91％,62％,57％,and 30％,respectively(P＜0.01).N stage could significantly affect the prognosis.The 5-year OS rate of T1b patients was lower than that of T1a and T2 stage(67％vs.90％vs.71％,P=0.003).Of the 24 patients with T1b stage,17 cases received inguinal lymphadenectomy and 7 cases not.The 5-year OS rate of T1b who received lymphadenectomy,who not and T2 group were 73％,57％and 71％respectively(P=0.22).Multivariate Cox analysis showed that N stage(HR=4.55,95％CI 2.64-7.85,P＜0.01)and tumor grade(HR=2.09,95％CI 1.09-4.02,P=0.03)were independent factors which could affect the prognosis.Conclusions N stage and tumor grade were independent factors which could affect the prognosis.The poorer the tumor grade,the worse the prognosis.Inguinal lymphadenectomy could improve the prognosis of patients with T1bstage.
万方数据
维普
