Abstract：
OBJECTIVE: Mohs micrographic surgery (MMS) is a low-risk penile cancer management option. However, contemporary patients\' short-term oncologic control and preoperative characteristics predicting reconstruction needs are undefined. This study assesses MMS\'s oncologic efficacy for low-risk penile cancer and identifies baseline predictors of post-resection reconstruction referral.
METHODS: We retrospectively reviewed 73 adult males with 78 penile cutaneous malignancies treated with MMS from 2005 to 2019. Patients underwent MMS with or without surgical reconstruction. Demographic information, MMS operative details, lesion pathology, and short-term outcomes were recorded. Descriptive statistics for all variables were calculated, and logistic regression identified predictive factors for urologic referral for complex reconstruction.
RESULTS: Seventy-three men with 78 lesions, all staged ≤ cT1a prior to MMS, were identified. Twenty-one men were found to have invasive SCC. Median follow-up was 2.0 years (IQR 0.8-5.2 years). MMS was able to clear the disease in 90.4% of cases. One patient had disease related death following progression. Dermatology closed primarily in 68% of patients. Twenty percent of patients had a complication, most commonly poor wound healing. On univariate and multivariate linear regression analysis, lesion size > 3 cm and involvement of the glans independently predicted the need for referral to a reconstructive surgeon.
CONCLUSIONS: MMS for penile cancer appears to provide sound oncologic control in the properly selected patient. Involvement of a reconstructive surgeon may be needed for glandular and large lesions, necessitating early referral to a comprehensive multidisciplinary care team.
METHODS: We retrospectively reviewed 73 adult males with 78 penile cutaneous malignancies treated with MMS from 2005 to 2019. Patients underwent MMS with or without surgical reconstruction. Demographic information, MMS operative details, lesion pathology, and short-term outcomes were recorded. Descriptive statistics for all variables were calculated, and logistic regression identified predictive factors for urologic referral for complex reconstruction.
RESULTS: Seventy-three men with 78 lesions, all staged ≤ cT1a prior to MMS, were identified. Twenty-one men were found to have invasive SCC. Median follow-up was 2.0 years (IQR 0.8-5.2 years). MMS was able to clear the disease in 90.4% of cases. One patient had disease related death following progression. Dermatology closed primarily in 68% of patients. Twenty percent of patients had a complication, most commonly poor wound healing. On univariate and multivariate linear regression analysis, lesion size > 3 cm and involvement of the glans independently predicted the need for referral to a reconstructive surgeon.
CONCLUSIONS: MMS for penile cancer appears to provide sound oncologic control in the properly selected patient. Involvement of a reconstructive surgeon may be needed for glandular and large lesions, necessitating early referral to a comprehensive multidisciplinary care team.
摘要：
目的：Mohs显微手术（MMS）是一种低风险的阴茎癌治疗选择。然而,当代患者的短期肿瘤控制和术前特征预测重建需求是不明确的。本研究评估了MMS对低风险阴茎癌的肿瘤疗效，并确定了切除后重建转诊的基线预测因素。
方法：我们回顾性分析了2005年至2019年接受MMS治疗的73例成年男性和78例阴茎皮肤恶性肿瘤。患者接受有或没有手术重建的MMS。人口统计信息,彩信操作详情,病变病理,并记录短期结局.计算了所有变量的描述性统计数据，和逻辑回归确定了泌尿外科转诊进行复杂重建的预测因素。
结果：73名男性有78个病灶，彩信前所有分级≤cT1a，已确定。21名男性被发现患有侵袭性SCC。中位随访时间为2.0年（IQR0.8-5.2年）。MMS能够在90.4%的病例中清除疾病。一名患者在进展后出现疾病相关死亡。皮肤科主要在68％的患者中关闭。20%的病人有并发症,最常见的伤口愈合不良。在单变量和多变量线性回归分析中，病变大小>3cm和受累的龟头独立预测需要转诊给重建外科医生.
结论：阴茎癌的MMS似乎在正确选择的患者中提供了良好的肿瘤控制。对于腺体和大型病变，可能需要重建外科医生的参与，需要尽早转诊到全面的多学科护理团队。
方法：我们回顾性分析了2005年至2019年接受MMS治疗的73例成年男性和78例阴茎皮肤恶性肿瘤。患者接受有或没有手术重建的MMS。人口统计信息,彩信操作详情,病变病理,并记录短期结局.计算了所有变量的描述性统计数据，和逻辑回归确定了泌尿外科转诊进行复杂重建的预测因素。
结果：73名男性有78个病灶，彩信前所有分级≤cT1a，已确定。21名男性被发现患有侵袭性SCC。中位随访时间为2.0年（IQR0.8-5.2年）。MMS能够在90.4%的病例中清除疾病。一名患者在进展后出现疾病相关死亡。皮肤科主要在68％的患者中关闭。20%的病人有并发症,最常见的伤口愈合不良。在单变量和多变量线性回归分析中，病变大小>3cm和受累的龟头独立预测需要转诊给重建外科医生.
结论：阴茎癌的MMS似乎在正确选择的患者中提供了良好的肿瘤控制。对于腺体和大型病变，可能需要重建外科医生的参与，需要尽早转诊到全面的多学科护理团队。
