摘要
目的比较T1G1—3，cN0阴茎鳞状细胞癌（SCCP）患者肿瘤特异性死亡率（CSM）和其他原因导致的死亡率（OCM）。方法2004年至2009年SEER数据库诊断为SCCP分期为T1G1—3，cN0患者641例。采用Fine和Gray竞争风险模型估计不同肿瘤分级的CSM，使用Gray检验比较各组的CSM，再利用竞争风险回归模型探索影响CSM的因素。结果原发肿瘤切除术（PTE）后5年，发生CSM和OCM分别为12．38％和30．60％。根据肿瘤分级（G1、G2、G3）分为三组，各组术后5年CSM分别为7．34％、15．05％和17．47％，差异有统计学意义（，〈0．05）；术后5年OCM分别为29．52％、28．45％和37．69％，差异无统计学意义（P〉0．05）。肿瘤分级为G3的患者相比于G1的患者有2．45倍风险发生CSM（95％CI1．09．5．62，P〈0．05）。然而未发现G2期患者相比G1期患者发生CSM的风险更高。结论T1G3和T1G2患者术后5年出现CSM概率较高，适合进行腹股沟淋巴结清扫术（ILND）；而T1G1术后5年发生CSM较低，积极随访监测是较好的选择。
Objective To comparatively analyze cancer-specific mortality （CSM） and other-cause mortality （OCM） in individuals with stage T1G1-3 clinically node-negative （cN0） squamous cell carcinoma of the penis （SCCP）. Methods Total of 641 SCCP patients treated with primary tumor excision （PTE） without an inguinal lymph node dissection （ILND） were identified relying on the Surveillance, Epidemiology and End Results （SEER） registries between 2004 and 2009. Cumulative incidence plots were used to depict the effect of CSM relative to OCM. Competing risk regression analysis was used to quantify the risk of CSM or OCM under normalization of age, race and tumor grade. Results The 5-year CSM and OCM rates after PTE were 12.38% and 30.06% respectively. The 5-year CSM without ILND were 7.34%, 15.05% and 17.47% in patients with T1G1, T1G2 and T1G3 （,~〈0.05）. The 5-year OCM rates were 29.52%, 28.47% and 37.69% in patients with T1G1, T1G2 and T1G3 （P〉0.05）. Patients with G3 had 2-fold higher CSM rates than those with G1（95%CI 1.09-5.62, P〈0.05）. However, such results were not found in patients with G2. Conclusion The T1G3 and T1G2 patients are suitable for ILND due to high CSM rates. T1 G1 patients are preferred to long term active follow-up due to relatively low CSM rates.
出处
《中国男科学杂志》
CAS
CSCD
北大核心
2014年第1期9-12,17,共5页
Chinese Journal of Andrology
