早期阴茎癌患者阴茎保留术预后影响因素分析  

Prognostic factors of penis-sparing surgery for early-stage penile cancer

作　　者：张嘉宜[1] 宋乐彬 王亚民[1] 陈晨[1] 王仪春[1] 宋宁宏[1] 顾民[1] 

机构地区：[1]南京医科大学第一附属医院泌尿外科,江苏南京210029 [2]南京医科大学第一临床医学院,江苏南京210029

出　　处：《中华男科学杂志》2016年第5期401-405,共5页National Journal of Andrology

基　　金：江苏省"六大人才高峰"高层次人才项目(2012-WSN-020);江苏省"333高层次人才培养工程"(2011.Ⅲ-26110);江苏省自然科学基金(BK20131442)~~

摘　　要：目的：探讨影响早期阴茎癌患者阴茎保留术预后的因素。方法：回顾性分析2007年1月至2014年12月行阴茎保留术的早期阴茎癌患者45例,年龄23~65岁,平均45.6岁。应用Kaplan-Meier生存分析法计算无局部复发生存率,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、婚姻状况、肿瘤原发部位、肿瘤大小、术后吸烟及性生活情况、组织学分级、TNM分期。结果：所有患者1年无局部复发生存率为95.5%,3年无局部复发生存率为52.2%。Cox多因素回归分析表明肿瘤组织学分级（P=0.039）及术后性生活变化（P=0.049）对阴茎保留术的预后有统计学意义。Logistic回归分析发现患者年龄对于组织学分级有显著影响（P=0.014）。结论：组织学分级和术后性生活情况的改变是阴茎保留术预后的独立风险因素,而年龄通过影响组织学分级与患者预后相关。Objective： To investigate the factors influencing the prognosis of penis-sparing surgery（ PSS） for early-stage penile cancer. Methods： We retrospectively studied the clinical data about 45 cases of early-stage penile cancer treated by PSS from January2007 to December 2014. We calculated the rate of local recurrence-free survival by the Kaplan-Meier method,and conducted univariate and multivariate COX regression analyses on the relevant factors including the patient＇s age,marital status,tumor location,tumor size,postoperative sexual life,histological grade,and TNM stage. Results： One-year and three-year local recurrence-free survival rates were 95. 5% and 52. 2%,respectively. Multivariate analysis demonstrated that the histological grade（ P = 0. 039） and postoperative sexual life（ P = 0. 049） were independent factors for the prognosis of PSS. Logistic regression showed the patient＇s age to be significantly associated with histological grade（ P = 0. 014）. Conclusion： Histological grade and postoperative sexual life are important independent prognostic factors of PSS for early-stage penile cancer,and the patient＇s age is associated with the prognosis of PSS through its influence on the tumor grade.

关 键 词：早期阴茎癌 阴茎保留术 预后 局部复发 

分 类 号：R737.27[医药卫生—肿瘤]