阴茎癌行腹股沟淋巴结根治术的疗效

2023-06-22 10:22

根治性腹股沟淋巴结切除术(RRERnd)提供了出色的肿瘤学结果,同时降低了发病率。较晚期结节病患者的生存率较低,强调需要辅助性化疗。

Cite this article

Schifano, N., Fallara, G., Rezvani, S. et al. Outcomes following radical inguinal lymphadenectomy for penile cancer using a fascial-sparing surgical technique. World J Urol 41, 1581–1588 (2023).

目的

介绍我们的手术方法,并报告肿瘤的结果和并发症率,在阴茎癌患者的腹股沟淋巴结合并CN+疾病中,使用束束根治性腹股沟淋巴结切除术(RRERnd)。

方法

在10年的时间里,在两个专门的阴茎癌中心对421名患者进行了660次治疗。这项技术使用腹股沟下切口,在任何可触及的节点上切除一个椭圆形的皮肤。第一步是鉴定和保存斯卡帕和露营者的筋膜。所有腹股沟浅淋巴结均在该筋膜层下整块切除,并保留皮下静脉和拿膜。只要有可能,隐静脉就可以幸免。回顾性收集和分析患者特征、肿瘤学结果和围手术期发病率。卡普兰-梅尔曲线估计肿瘤特异性生存功能(CSS)术后。

结果

Median (interquartile range, IQR) follow-up was 28 (14–90) months. A median (IQR) number of 8.0 (6.5–10.5) nodes were removed per groin. A total of 153 postoperative complications (36.1%) occurred, including 50 conservatively managed wound infections (11.9%), 21 cases of deep wound dehiscence (5.0%), 104 cases of lymphoedema (24.7%), 3 cases of deep vein thrombosis (0.7%), 1 case of pulmonary embolism (0.2%), and 1 case of postoperative sepsis (0.2%). The 3-year CSS was 86% (95%Confidence Interval [95% CI] 77–96), 83% (95% CI 72–92), 58% (95% CI 51–66), respectively, for the pN1, pN2 and pN3 patients ( P < 0.001), compared to a 3-year CSS of 87% (95% CI 84–95) for the pN0 patients.

结论

根治性腹股沟淋巴结切除术(RRERnd)提供了出色的肿瘤学结果,同时降低了发病率。较晚期结节病患者的生存率较低,强调需要辅助性化疗。