腹股沟淋巴结清扫在阴茎癌治疗中的应用
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摘要
阴茎癌是一种比较少见的恶性肿瘤。其发病率具有显著的地域差异性,其中,在欧美等发达国家具有较低的发病率,然而,在非洲、南美洲以及亚洲的部分发展中国家或地区,阴茎癌的发病率较高。目前,阴茎癌的主要治疗方法包括:保留阴茎的治疗(微小病灶切除术);阴茎部分切除术;阴茎根治性切除术。区域淋巴结有无转移、转移程度、能否根治切除是影响阴茎癌患者生存率的决定性因素。阴茎癌最早和最常见的区域淋巴结转移部位为腹股沟淋巴结,本文主要阐述了传统开放手术、改良的腹股沟淋巴结清扫术、腹腔镜与机器人辅助腹股沟淋巴结清扫手术在阴茎癌治疗中的应用及各手术方式常见并发症及防治措施。
Penile neoplasms is a rare malignant tumor in clinical,its incidence is obvious differently in different regions on the world,it′s with a low incidence for the developed countries,such as Europe and the United States. But,the penile neoplasms′ incidence is higher in Africa,South America,parts of Asia such as India because of the poor health condition. The current treatment methods for penile neoplasms mainly include:Phallic preserving surgery. Partial phallic resection;Radical resection of the penis. Regional lymph node invaded or not for the penile neoplasms patients,and a radical inguinal lymph node dissection is the decisive factor that affect the patient′s survival rate. The inguinal lymph nodes are the earliest and most common regional lymph node metastases of penile carcinoma.This paper has reviewed the application of the open inguinal lymph node dissection,modified inguinal lymphadenectomy,video endoscopic inguinal lymphadenectomy,robotic-assisted inguinal lymphadenectomy in penile neoplasms patients,and the major complications of each surgery method.
Penile neoplasms is a rare malignant tumor in clinical,its incidence is obvious differently in different regions on the world,it′s with a low incidence for the developed countries,such as Europe and the United States. But,the penile neoplasms′ incidence is higher in Africa,South America,parts of Asia such as India because of the poor health condition. The current treatment methods for penile neoplasms mainly include:Phallic preserving surgery. Partial phallic resection;Radical resection of the penis. Regional lymph node invaded or not for the penile neoplasms patients,and a radical inguinal lymph node dissection is the decisive factor that affect the patient′s survival rate. The inguinal lymph nodes are the earliest and most common regional lymph node metastases of penile carcinoma.This paper has reviewed the application of the open inguinal lymph node dissection,modified inguinal lymphadenectomy,video endoscopic inguinal lymphadenectomy,robotic-assisted inguinal lymphadenectomy in penile neoplasms patients,and the major complications of each surgery method.
引文
[1]Mobilio G,Ficarra V.Genital treatment of penile carcinoma[J].Curr Opin Urol,2001,11(3):299-304.
[2]Daling JR,Madeleine MM,Johnson LG,et al.Penile cancer:importance of circumcision,human papillomavirus and smoking in situ and invasive disease[J].Int J Cancer,2005,116(4):606-616.
[3]Tsen HF,Morgenstern H,Mack T,et al.Risk factors for penile cancer:results of a population-based case-control study in Los Angeles County(United States)[J].Cancer Causes Control,2001,12(3):267-277.
[4]Dillner J,von Krogh G,Horenblas S,et al.Etiology of squamous cell carcinoma of the penis[J].Scand J Urol Nephrol Suppl,2000,205:189-193.
[5]Pascual A,Pariente M,Godinez JM,et al.High prevalence of human papillomavirus 16 in penile carcinoma[J].Histol Histopathol,2007,22(2):177-183.
[6]Picconi MA,Eijan AM,Distefano AL,et al.Human papillomavirus(HPV)DNA in penile carcinomas in Argentina:analysis of primary tumors and lymph nodes[J].J Med Virol,2000,61(1):65-69.
[7]da Costa WH,Rosa de Oliveira RA,Santana TB,et al.Prognostic factors in patients with penile carcinoma and inguinal lymph node metastasis[J].Int J Urol,2015,22(7):669-673.
[8]Djajadiningrat RS,van Werkhoven E,Horenblas S.Prophylactic pelvic lymph node dissection in patients with penile cancer[J].J Urol,2015,193(6):1976-80.
[9]Schlenker B,Tilki D,Seitz M,et al.Organ-preserving neodymium-yttriumaluminium-garnet laser therapy for penile carcinoma:a long-term follow-up[J].BJU Int,2010,106(6):786-790.
[10]Crevoisier R,Slimane K,Sanfilippo N,et al.Long term results of brachytherapy for carcinoma of the glans(N-or N+)[J].Int J Radiol Biol Phys,2009,74(4):1150-1156.
[11]McDougal WS,Kirchner FK Jr,Edwards RH,et al.Treatment of carcinoma of the penis:the case for primary lymphadenectomy[J].J Urol,1986,136(1):38-41.
[12]Horenblas S,van Tinteren H,Delemarre JF,et al.Squamous cell carcinoma of the penis.II.Treatment of the primary tumor[J].J Urol,1992,147(6):1533-1538.
[13]Wein AJ,Kavoussi LR,novick AC,et al.Campbell-Walsh Urology[M].9th ed.Philadelphia:Saunders Elsevier,2007:1936-1937.
[14]Ornellas AA,Kinchin EW,Nobrega BL,et al.Surgical treatment of invasive squamous cell carcinoma of the penis:Brazilian National Cancer Institute long-term experience[J].J Surg oncol,2008,97(6):487-495.
[15]McDougal WS.Carcinoma of the penis:improved survival by early regional lymphadenectomy based on the histological grade and depth of invasion of the primary lesion[J].J Urol,1995,154(4):1364-1366.
[16]Cabanas RM.An approach for the treatment of penile carcinoma[J].Cancer,1977,39(2):456-466.
[17]Pettaway CA,Pisters LL,Dinuey CP,et al.Sentinel lymph node dissection for penis carcinoma:the MD Anderson cancer center experience[J].J Urol,1995,154(6):1999-2003.
[18]Ficarra V,Zattoni F,Artibani W,et al.Penile Cancer Project Members.Nomogram predictive of pathological inguinal lymph node involvement in patients with squamous cell carcinoma of the penis[J].J Urol,2006,175(5):1700-1705.
[19]Catalona WJ.M0dified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins:technique and preliminary results[J].J Urol,1988,140(2):306-310.
[20]Cui Y,Chen H,Liu L,et al.Saphenous vein sparing during laparoscopic bilateral inguinal lymphadenectomy for penile carcinoma patients[J].Int Urol Nephrol,2016,48(3):363-366.
[21]Gopman JM,Djajadiningrat RS,Baumgarten AS,et al.Predicting postoperative complications of inguinal lymph node dissection for penile cancer in an international multicentre cohort[J].BJU Int,2015,116(2):196-201.
[22]Lopes A,Rossi BM,Fonseca FP,Morini S.Unreliability of modified inguinal lymphadenectomy for clinicat staging of penile carcinoma[J].Cancer,1996,77(10):2099-2102.
[23]D′Ancona CA,de Lueena RG,Qucme FA,et al.Long-term follow-up of penile carcinoma treated with penectomy and bilateral modified inguinal lymphadenectomy[J].J Urol,2004,172(2):498-501.
[24]Tobias-Machado M,Tavares A,Molina WR Jr,et al.Comparative study of video endoscopic inguinal lymphadenectomy through a hypogastric vs leg subcutaneous approach for penile cancer[J].Arch Esp Urol,2006,59(8):849-852.
[25]Yuan P,Zhao C,Liu Z,et al.Comparative study of video endoscopic inguinal lymphadenectomy via a hypogastric versus leg subcutaneous approach for penile cancer[J].J Endourol,2018,32(1):66-72
[26]Delman KA,Kooby DA,Rizzo M,et al.Initial experience with videoscopie inguinal lymphadenectomy[J].Ann Surg Oncol,2011,18(4):977-982.
[27]Yadav SS,Tomar V,Bhattar R,et al.Video endoscopic inguinal lymphadenectomy vs open inguinal lymphadenectomy for carcinoma penis:expanding role and comparison of outcomes[J].Urology,2018,113:79-84.
[28]Tobias-Machado M,Tavares A,Ornellas AA,et al.Video endoscopic inguinal lymphadenectomy:a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma[J].J UroI,2007,177(3):953-957.
[29]Josephson DY,Jacobsohn KM,Link BA,et al.Robotic-assisted endoscopic inguinal lymphadenectomy[J].Urology,2009,73(6):1424-1425.
[30]Dogra PN,Saini AK,Singh P.Robotic-assisted inguinal lymph node dissection:A preliminary report[J].Indian J Urol,2011,27(3):424-427.
[31]Matin SF,Cormier JN,Ward JF,et al.Phase 1prospective evaluation of the oncological adequacy of robotic assisted videoendoscopic inguinal lymphadenectomy in patients with penile carcinoma[J].BJU Int,2013,111(7):1068-1074.
[32]Elsamra SE,Poch MA.Robotic inguinal lymphadenectomy for penile cancer:the why,how,and what[J].Transl Androl Urol,2017,6(5):826-832.
[33]Kharadjian TB,Matin SF,Pettaway CA.Early experience of robotic-assisted inguinal lymphadenectomy:review of surgical outcomes relative to alternative approaches[J].Current urology reports,2014,15(6):412.
[34]Matin SF,Cormier JN,Ward JF,et al.Phase 1 prospective evaluation of the oncological adequacy of robotic assisted videoendoscopic inguinal lymphadenectomy in patients with penile carcinoma[J].BJU international,2013,111(7):1068-1074.
[35]詹友庆,朱少立.髂-腹腹股沟淋巴结清扫术在阴茎癌治疗中的应用[J].中山医科大学学报,1990,11(3):79-80.
[36]Crawford ED.Radical ilioinguinal lymphadenectomy[J].Urol Clin North Am,1984,11(3):543-552.
[37]Kim WT,Ham WS,Koo KC,et al.Efficacy of octreotide for management of lymphorrhea after pelvic lymph node dissection in radical prostatectomy[J].Urology,2010,76(2):398-401.
[38]Klode J1,Kl?tgen K,K?rber A,et al.Polidocanol foam sclerotherapy is a new and effective treatment for post-opreative lymphorrhea and lymphocele[J].J Eur Acad Dermatol Venereol,2010,24(8):904-909.
[39]Gallo Rolania FJ,Beneitez Alvarez ME,Izquierdo García FM.The role of inguinal lymphadenectomy in epidermoid carcinoma of the penis.Use of Ligasure and analysis of the results[J].Arch Esp Urol,2002,55(5):535-538.
[40]Donat SM.Cozzi PJ,Herr HW.Surgery of Penile and Urethral Carcinoma[M].Walsh,Patrick C.Campbell′s urology.8th ed.Philadelphia:W.13.Saunders,2002:2983.
[41]Stancik I,Holtl W.Penile cancer:review of the recent literature[J].Curr Opin Urol,2003,13(6):467-472.
[42]Kroon BK,Horenblas S,Lont AP,et al.Patients with penile carcinoma benefit from immediate resection of clinically occult lymph node metastases[J].J Urol,2005,173(3):816-819.
[43]Johnson DE,Lo RK.Management of regional lymph nodes in penile carcinoma.Five-year results following therapeutic groin dissections[J].Urology,1984,24(4):308-311.
[44]邹子君,尧凯,周芳坚,等.阴茎癌切除同期行改良根治性腹股沟淋巴结清扫术的可行性研究[J].中华泌尿外科杂志,2011,32(12):803-806.
[45]Ravi R.Prophylactic lymphadenectomy VS observation VS inguinal biopsy in node-negative patients with invasive carcinoma of the penis[J].Jpn J Clin Oncol,1993,23(1):53-58.
[46]Heyns CF,Fleshner N,Sangar V.Management of the lymph nodes in penile cancer[J].Urology,2010,76(2 Suppl 1):S43-57.
[2]Daling JR,Madeleine MM,Johnson LG,et al.Penile cancer:importance of circumcision,human papillomavirus and smoking in situ and invasive disease[J].Int J Cancer,2005,116(4):606-616.
[3]Tsen HF,Morgenstern H,Mack T,et al.Risk factors for penile cancer:results of a population-based case-control study in Los Angeles County(United States)[J].Cancer Causes Control,2001,12(3):267-277.
[4]Dillner J,von Krogh G,Horenblas S,et al.Etiology of squamous cell carcinoma of the penis[J].Scand J Urol Nephrol Suppl,2000,205:189-193.
[5]Pascual A,Pariente M,Godinez JM,et al.High prevalence of human papillomavirus 16 in penile carcinoma[J].Histol Histopathol,2007,22(2):177-183.
[6]Picconi MA,Eijan AM,Distefano AL,et al.Human papillomavirus(HPV)DNA in penile carcinomas in Argentina:analysis of primary tumors and lymph nodes[J].J Med Virol,2000,61(1):65-69.
[7]da Costa WH,Rosa de Oliveira RA,Santana TB,et al.Prognostic factors in patients with penile carcinoma and inguinal lymph node metastasis[J].Int J Urol,2015,22(7):669-673.
[8]Djajadiningrat RS,van Werkhoven E,Horenblas S.Prophylactic pelvic lymph node dissection in patients with penile cancer[J].J Urol,2015,193(6):1976-80.
[9]Schlenker B,Tilki D,Seitz M,et al.Organ-preserving neodymium-yttriumaluminium-garnet laser therapy for penile carcinoma:a long-term follow-up[J].BJU Int,2010,106(6):786-790.
[10]Crevoisier R,Slimane K,Sanfilippo N,et al.Long term results of brachytherapy for carcinoma of the glans(N-or N+)[J].Int J Radiol Biol Phys,2009,74(4):1150-1156.
[11]McDougal WS,Kirchner FK Jr,Edwards RH,et al.Treatment of carcinoma of the penis:the case for primary lymphadenectomy[J].J Urol,1986,136(1):38-41.
[12]Horenblas S,van Tinteren H,Delemarre JF,et al.Squamous cell carcinoma of the penis.II.Treatment of the primary tumor[J].J Urol,1992,147(6):1533-1538.
[13]Wein AJ,Kavoussi LR,novick AC,et al.Campbell-Walsh Urology[M].9th ed.Philadelphia:Saunders Elsevier,2007:1936-1937.
[14]Ornellas AA,Kinchin EW,Nobrega BL,et al.Surgical treatment of invasive squamous cell carcinoma of the penis:Brazilian National Cancer Institute long-term experience[J].J Surg oncol,2008,97(6):487-495.
[15]McDougal WS.Carcinoma of the penis:improved survival by early regional lymphadenectomy based on the histological grade and depth of invasion of the primary lesion[J].J Urol,1995,154(4):1364-1366.
[16]Cabanas RM.An approach for the treatment of penile carcinoma[J].Cancer,1977,39(2):456-466.
[17]Pettaway CA,Pisters LL,Dinuey CP,et al.Sentinel lymph node dissection for penis carcinoma:the MD Anderson cancer center experience[J].J Urol,1995,154(6):1999-2003.
[18]Ficarra V,Zattoni F,Artibani W,et al.Penile Cancer Project Members.Nomogram predictive of pathological inguinal lymph node involvement in patients with squamous cell carcinoma of the penis[J].J Urol,2006,175(5):1700-1705.
[19]Catalona WJ.M0dified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins:technique and preliminary results[J].J Urol,1988,140(2):306-310.
[20]Cui Y,Chen H,Liu L,et al.Saphenous vein sparing during laparoscopic bilateral inguinal lymphadenectomy for penile carcinoma patients[J].Int Urol Nephrol,2016,48(3):363-366.
[21]Gopman JM,Djajadiningrat RS,Baumgarten AS,et al.Predicting postoperative complications of inguinal lymph node dissection for penile cancer in an international multicentre cohort[J].BJU Int,2015,116(2):196-201.
[22]Lopes A,Rossi BM,Fonseca FP,Morini S.Unreliability of modified inguinal lymphadenectomy for clinicat staging of penile carcinoma[J].Cancer,1996,77(10):2099-2102.
[23]D′Ancona CA,de Lueena RG,Qucme FA,et al.Long-term follow-up of penile carcinoma treated with penectomy and bilateral modified inguinal lymphadenectomy[J].J Urol,2004,172(2):498-501.
[24]Tobias-Machado M,Tavares A,Molina WR Jr,et al.Comparative study of video endoscopic inguinal lymphadenectomy through a hypogastric vs leg subcutaneous approach for penile cancer[J].Arch Esp Urol,2006,59(8):849-852.
[25]Yuan P,Zhao C,Liu Z,et al.Comparative study of video endoscopic inguinal lymphadenectomy via a hypogastric versus leg subcutaneous approach for penile cancer[J].J Endourol,2018,32(1):66-72
[26]Delman KA,Kooby DA,Rizzo M,et al.Initial experience with videoscopie inguinal lymphadenectomy[J].Ann Surg Oncol,2011,18(4):977-982.
[27]Yadav SS,Tomar V,Bhattar R,et al.Video endoscopic inguinal lymphadenectomy vs open inguinal lymphadenectomy for carcinoma penis:expanding role and comparison of outcomes[J].Urology,2018,113:79-84.
[28]Tobias-Machado M,Tavares A,Ornellas AA,et al.Video endoscopic inguinal lymphadenectomy:a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma[J].J UroI,2007,177(3):953-957.
[29]Josephson DY,Jacobsohn KM,Link BA,et al.Robotic-assisted endoscopic inguinal lymphadenectomy[J].Urology,2009,73(6):1424-1425.
[30]Dogra PN,Saini AK,Singh P.Robotic-assisted inguinal lymph node dissection:A preliminary report[J].Indian J Urol,2011,27(3):424-427.
[31]Matin SF,Cormier JN,Ward JF,et al.Phase 1prospective evaluation of the oncological adequacy of robotic assisted videoendoscopic inguinal lymphadenectomy in patients with penile carcinoma[J].BJU Int,2013,111(7):1068-1074.
[32]Elsamra SE,Poch MA.Robotic inguinal lymphadenectomy for penile cancer:the why,how,and what[J].Transl Androl Urol,2017,6(5):826-832.
[33]Kharadjian TB,Matin SF,Pettaway CA.Early experience of robotic-assisted inguinal lymphadenectomy:review of surgical outcomes relative to alternative approaches[J].Current urology reports,2014,15(6):412.
[34]Matin SF,Cormier JN,Ward JF,et al.Phase 1 prospective evaluation of the oncological adequacy of robotic assisted videoendoscopic inguinal lymphadenectomy in patients with penile carcinoma[J].BJU international,2013,111(7):1068-1074.
[35]詹友庆,朱少立.髂-腹腹股沟淋巴结清扫术在阴茎癌治疗中的应用[J].中山医科大学学报,1990,11(3):79-80.
[36]Crawford ED.Radical ilioinguinal lymphadenectomy[J].Urol Clin North Am,1984,11(3):543-552.
[37]Kim WT,Ham WS,Koo KC,et al.Efficacy of octreotide for management of lymphorrhea after pelvic lymph node dissection in radical prostatectomy[J].Urology,2010,76(2):398-401.
[38]Klode J1,Kl?tgen K,K?rber A,et al.Polidocanol foam sclerotherapy is a new and effective treatment for post-opreative lymphorrhea and lymphocele[J].J Eur Acad Dermatol Venereol,2010,24(8):904-909.
[39]Gallo Rolania FJ,Beneitez Alvarez ME,Izquierdo García FM.The role of inguinal lymphadenectomy in epidermoid carcinoma of the penis.Use of Ligasure and analysis of the results[J].Arch Esp Urol,2002,55(5):535-538.
[40]Donat SM.Cozzi PJ,Herr HW.Surgery of Penile and Urethral Carcinoma[M].Walsh,Patrick C.Campbell′s urology.8th ed.Philadelphia:W.13.Saunders,2002:2983.
[41]Stancik I,Holtl W.Penile cancer:review of the recent literature[J].Curr Opin Urol,2003,13(6):467-472.
[42]Kroon BK,Horenblas S,Lont AP,et al.Patients with penile carcinoma benefit from immediate resection of clinically occult lymph node metastases[J].J Urol,2005,173(3):816-819.
[43]Johnson DE,Lo RK.Management of regional lymph nodes in penile carcinoma.Five-year results following therapeutic groin dissections[J].Urology,1984,24(4):308-311.
[44]邹子君,尧凯,周芳坚,等.阴茎癌切除同期行改良根治性腹股沟淋巴结清扫术的可行性研究[J].中华泌尿外科杂志,2011,32(12):803-806.
[45]Ravi R.Prophylactic lymphadenectomy VS observation VS inguinal biopsy in node-negative patients with invasive carcinoma of the penis[J].Jpn J Clin Oncol,1993,23(1):53-58.
[46]Heyns CF,Fleshner N,Sangar V.Management of the lymph nodes in penile cancer[J].Urology,2010,76(2 Suppl 1):S43-57.