阴茎佩吉特病的手术策略和预后：中国三级中心的一项大型回顾性队列研究

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-04-01 DOI:10.1016/j.ejso.2025.110004

Xiang Wan , Dachao Zheng , Dajun Gao , Minkai Xie, Jianshu Ni, Bin Xu, Haijun Yao

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引用次数: 0

摘要

背景：penoscrotal Paget’s disease （PPD）是一种罕见的皮肤恶性肿瘤，在重建、治疗策略和预后方面仍未达成共识。我们的目的是阐明临床特征，手术结果和预后，提出一个量身定制的会阴重建（PR）策略。方法：我们对2004年5月至2021年2月间一家大型三级医院病理登记的233例PPD病例进行了回顾性队列研究。分析患者的临床特点、手术治疗方式、性功能及预后。采用Kaplan-Meier分析、单因素和多因素Cox回归分析确定预后因素。结果所有术后缺损均采用基于spr策略的重建。Kaplan-Meier分析显示，高pr评分（≥4）组的无病生存期（DFS）较低pr评分（≤3）组差。年龄、肿瘤厚度和淋巴结浸润成为总生存（OS）的独立预测因子。结论早期评估和干预是预防垂直及淋巴结侵犯的关键。广泛的局部切除提供了低复发率，高总体存活率和可接受的性功能。PR策略是一种很有前景的评估病变、指导重建和预测预后的方法，有可能改善这种罕见恶性肿瘤的治疗和管理。

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Surgical strategy and outcomes of penoscrotal Paget's disease: A large retrospective cohort study in a Chinese tertiary center

Background

Penoscrotal Paget's disease (PPD) is a rare malignant skin tumor, and consensus on reconstruction, treatment strategies, and prognosis remains elusive. We aimed to elucidate the clinical features, surgical outcomes, and prognosis, proposing a tailored Perineal Reconstruction (PR) strategy.

Methods

We conducted a retrospective cohort study using pathologically confirmed 233 PPD cases from a large tertiary hospital pathology registry between May 2004 and February 2021. Clinical features, surgical treatment patterns, sexual function, and prognosis were analyzed. Kaplan-Meier analysis, univariate and multivariate Cox regression were performed to identify prognostic factors.

Results

PR strategy-based reconstruction was applied on all postsurgical defects. Kaplan-Meier analysis indicated worse disease free-survival (DFS) in the high-PR score (≥4) group compared to the low-PR score (≤3) group. Age, tumor thickness, and lymph node invasion emerged as independent predictors of overall survival (OS).

Conclusions

Early evaluation and intervention are crucial to prevent vertical and lymph node invasion. Wide local excision provides low recurrence, high overall survival rates, and acceptable sexual function. The PR strategy serves as a promising approach to assess lesions, guide reconstruction, and predict prognosis, potentially improving treatment and management of this rare malignancy.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.