Study On The Risk Factors Of Postoperative Prognosis In Patients With Penile Cancer

Objective :This study is to explore a variety of risk factors that affect the prognosis of patients with penile cancer after surgery,so as to provide more valuable information for the evaluation of the prognosis of patients with penile cancer after surgery,and further guide clinicians to make a more accurate evaluation of the prognosis of patients with penile cancer after surgery.Methods:The clinical data of 142 patients with penile cancer who were operated in urology and andrology Department of Affiliated Hospital of Qingdao University from2006 to 2018 were analyzed retrospectively.The collected data included age,smoking,tumor size,tumor location,tumor TNM stage,histopathological grade,preoperative peripheral blood neutrophil / lymphocyte value(neut)LPR,LMR,fibrinogen level,FIB,type of operation(penile preserved or not),and pathology of inguinal lymph nodes after operation The nature of nodes,PL)and so on.The data were divided into groups in detail,and the patients were investigated and followed up.The follow-up contents included whether the patients survived,whether they had regular reexamination and reexamination,whether they had relapse or metastasis,the cause of death,and the specific time of death.After further sorting out the data,the overall survival rate of the patients was calculated by Kaplan Meier survival analysis method,OS)and cancer specific survival,CSS)and draw the relevant survival curve,and use log rank test to analyze whether the above factors have statistical significance on the postoperative CSS of patients;bring the relevant factors that may affect the prognosis of patients into Cox regression model,carry out single factor and multi factor regression analysis,and further analyze the independent risk factors that affect the prognosis of penile cancer patients.Results:1.The overall survival rate(0s)of 142 patients with penile cancer was 95.0%,82.9% and75.2%,respectively,and the tumor specific survival rate(CSS)of 1,3 and 5 years was97.1%,89.0% and 83.7%,respectively.2.Kaplan Meier method and log rank test were used to analyze the relationship between each of the above factors and postoperative CSS of patients with penile cancer.The results showed that N stage(P = 0.010),histopathological grade(P = 0.029),NLR(P =0.026),LMR(P = 0.013),FIB(P = 0.003),PL property(P < 0.001)could be the important factors affecting the prognosis of patients,but the patients could not be found The age(P= 0.957),smoking status(P = 0.453),tumor size(P = 0.134),primary site of tumor(P =0.181),T stage(P = 0.157),operation mode(penile preservation or not)(P = 0.371)were significantly correlated with the prognosis,and the results were not statistically significant(P > 0.05).3.The results of single factor and multi factor regression analysis showed that PL(P =0.006)and FIB(P = 0.049)were independent risk factors for the prognosis of patients with penile cancer.Conclusion:The N stage,histopathological grade,NLR and LMR of penile cancer may be the important factors(P < 0.05),the preoperative FIB value(P = 0.049)and the postoperative PL property(P = 0.006)are the independent risk factors for the postoperative prognosis of penile cancer.The prognosis of patients with preoperative FIB? 390 mg / dl and postoperative PL positive are generally poor,both of which are powerful indexes for evaluating the survival and prognosis of patients.Therefore,as with other malignant tumors,it is still considered that early detection and treatment,especially radical surgery before the occurrence of inguinal lymph node metastasis,is still an important measure to improve the prognosis of penile cancer.At the same time,the comprehensive consideration of the patient's preoperative peripheral blood inflammatory cell ratio and FIB and other meaningful factors can more accurately infer the prognosis of the patient and guide the clinical medicine The next step of diagnosis and treatment is to reduce the recurrence rate and improve the survival rate.