We tested the feasibility and oncological outcomes after penile-sparing surgery (PSS) for local recurrent penile cancer after a previous glansectomy/partial penectomy. We retrospectively analysed 13 patients (1997–2022) with local recurrence of penile cancer after a previous glansectomy or partial penectomy. All patients underwent PSS: circumcision, excision, or laser ablation. First, technical feasibility, treatment setting, and complications (Clavien–Dindo) were recorded. Second, Kaplan–Meier plots depicted overall and local recurrences over time. Overall, 11 (84.5%) vs. 2 (15.5%) patients were previously treated with glansectomy vs. partial penectomy. The median (IQR) time to disease recurrence was 56 (13–88) months. Six (46%) vs. two (15.5%) vs. five (38.5%) patients were treated with, respectively, local excision vs. local excision + circumcision vs. laser ablation. All procedures, except one, were performed in an outpatient setting. Only one Clavien–Dindo 2 complication was recorded. The median follow-up time was 41 months. Overall, three (23%) vs. four (30.5%) patients experienced local vs. overall recurrence, respectively. All local recurrences were safely treated with salvage surgery. In conclusion, we reported the results of a preliminary analysis testing safety, feasibility, and early oncological outcomes of PSS procedures for patients with local recurrence after previous glansectomy or partial penectomy. Stronger oncological outcomes should be tested in other series to optimise patient selection.
本研究旨在评估既往接受过龟头切除术/部分阴茎切除术的局部复发性阴茎癌患者行保留阴茎手术（PSS）的可行性及肿瘤学结局。我们回顾性分析了1997年至2022年间13例既往接受龟头切除术或部分阴茎切除术后出现局部复发的阴茎癌患者。所有患者均接受PSS治疗，包括包皮环切术、局部切除术或激光消融术。首先记录技术可行性、治疗环境和并发症（Clavien–Dindo分级）。其次，采用Kaplan–Meier曲线描述总体复发和局部复发随时间的变化情况。总体而言，既往接受龟头切除术与部分阴茎切除术的患者分别为11例（84.5%）和2例（15.5%）。疾病复发的中位时间（四分位距）为56（13-88）个月。分别有6例（46%）、2例（15.5%）和5例（38.5%）患者接受局部切除术、局部切除术联合包皮环切术及激光消融术治疗。除一例外，所有手术均在门诊进行。仅记录到一例Clavien–Dindo 2级并发症。中位随访时间为41个月。总体而言，分别有3例（23%）和4例（30.5%）患者出现局部复发和总体复发。所有局部复发均通过挽救性手术得到安全治疗。综上所述，本研究报告了对既往龟头切除术或部分阴茎切除术后局部复发患者行PSS手术的安全性、可行性及早期肿瘤学结局的初步分析结果。未来需通过更多病例系列研究验证其更确切的肿瘤学结局，以优化患者选择。
肿瘤(癌症)患者之家