CAJ | 학술논문

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（P＜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%CI 1.09-5.62，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。
목적：비교T1G1-3，cN0음경린상세포암（SCCP）환자종류특이성사망솔（CSM）화기타원인도치적사망솔（OCM）。방법2004년지2009년SEER수거고진단위SCCP분기위T1G1-3，cN0환자641례。채용Fine화Gray경쟁풍험모형고계불동종류분급적CSM，사용Gray검험비교각조적CSM，재이용경쟁풍험회귀모형탐색영향CSM적인소。결과원발종류절제술（PTE）후5년，발생CSM화OCM분별위12.38%화30.60%。근거종류분급（G1、G2、G3）분위삼조，각조술후5년CSM분별위7.34%、15.05%화17.47%，차이유통계학의의（P＜0.05）；술후5년OCM분별위29.52%、28.45%화37.69%，차이무통계학의의（P＞0.05）。종류분급위G3적환자상비우G1적환자유2.45배풍험발생CSM（95%CI 1.09-5.62，P＜0.05）。연이미발현G2기환자상비G1기환자발생CSM적풍험경고。결론 T1G3화T1G2환자술후5년출현CSM개솔교고，괄합진행복고구림파결청소술（ILND）；이T1G1술후5년발생CSM교저，적겁수방감측시교호적선택。
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 (P<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. T1G1 patients are preferred to long term active follow-up due to relatively low CSM rates.