陰茎癌18例の臨床的観察

Abstract

A total of 18 cases of penile carcinoma (squamous cell carcinoma) encountered during the ten year period of 1967 through 1977 were studied. The age distribution of these cases showed that the patients in the 40's to the 60's accounted for 75% of the patients. Sixteen cases (88.9%) had phimosis. In 13 cases (72%) the inguinal lymph nodes were found swollen at the initial examination; and cancer metastases were found in six of them (33%). Chemotherapy with bleomycin was performed prior to surgery. This chemotherapy appeared effective in ten (62.5%) out of 16 cases. The bleomycin therapy failed to make surgery unnecessary in any of the cases, but two cases in which total penectomy was initially thought to be indicated could be treated by partial resection after bleomycin therapy. Of the 18 cases, 17 had surgery, and dissection of the iliac and inguinal lymph nodes was performed in four of them. Postoperative complications included urethral stricture in one, necrosis of the wound for dissection of lymph nodes in two, and lymphorrhea in two cases. Radiotherapy was performed for lymphorrhea and proved effective. Radiotherapy was used as the postoperative therapy. The 18 cases were classified by the Jackson staging to five stage I, seven stage II, five stage III and one stage IV cases. The crude 5-year survival rate was 100% in the cases staged I and II, 20.0% in those staged III, and 0% in those staged IV. The total crude 5-year survival rate was 61.5%.