放射治疗 (RT) 是 T1 阴茎鳞状细胞癌 (SCCP) 患者的替代治疗选择，其可行性和耐受性已得到证实。然而，从未将其与使用癌症特异性死亡率 (CSM) 作为终点的部分阴茎切除术 (PP) 进行直接比较。 在监测、流行病学和最终结果数据库 (2000-2020) 中，接受 RT 或 RT 治疗的 T1N0M0 SCCP 患者PP 被鉴定。本研究依赖于诊断年龄、肿瘤分期和肿瘤分级的 1:4 倾向评分匹配 (PSM)。随后，累积发生率图以及多变量竞争风险回归 (CRR) 模型解决了 CSM。此外，该研究还考虑了其​​他原因死亡率 (OCM) 的混杂效应。在 895 名 T1N0M0 SCCP 患者中，55 名 (6.1%) 接受了 RT，840 名 (93.9%) 接受了 PP。 RT 和 PP 患者的年龄分布相似（中位年龄为 70 岁 vs 70 岁），并且更常见的是 I 级或 II 级肿瘤（67.3% vs 75.8%）以及 T1a 期疾病（67.3% vs 74.3%）。 1:4 PSM 后，55 名 RT 患者中的 55 名 (100%) 与 840 名 PP 患者中的 220 名 (26.2%) 被纳入研究。从累积发病率图得出的 10 年 CSM 为 RT 的 25.4% 和 PP 的 14.4%。在多变量 CRR 模型中，RT 独立预测的 CSM 高于 PP（风险比，1.99；95% 置信区间，1.05-3.80；p = 0.04）。对于在社区接受治疗的 T1N0M0 SCCP 患者，RT 与近CSM 比 PP 高两倍。理想情况下，应进行基于三级医疗机构数据的验证研究，以测试这种 CSM 缺点是否仅在社区中有效。© 2024。外科肿瘤学会。

Radiotherapy (RT) represents an alternative treatment option for patients with T1 squamous cell carcinoma of the penis (SCCP), with proven feasibility and tolerability. However, it has never been directly compared with partial penectomy (PP) using cancer-specific mortality (CSM) as an end point.In the Surveillance, Epidemiology, and End Results database (2000-2020), T1N0M0 SCCP patients treated with RT or PP were identified. This study relied on 1:4 propensity score-matching (PSM) for age at diagnosis, tumor stage, and tumor grade. Subsequently, cumulative incidence plots as well as multivariable competing risks regression (CRR) models addressed CSM. Additionally, the study accounted for the confounding effect of other-cause mortality (OCM).Of 895 patients with T1N0M0 SCCP, 55 (6.1%) underwent RT and 840 (93.9%) underwent PP. The RT and PP patients had a similar age distribution (median age, 70 vs 70 years) and more frequently harbored grade I or II tumors (67.3% vs 75.8%) as well as T1a-stage disease (67.3% vs 74.3%). After 1:4 PSM, 55 (100%) of the 55 RT patients versus 220 (26.2%) of the 840 PP patients were included in the study. The 10-year CSM derived from the cumulative incidence plots was 25.4% for RT and 14.4% for PP. In the multivariable CRR models, RT independently predicted a higher CSM than PP (hazard ratio, 1.99; 95% confidence interval, 1.05-3.80; p = 0.04).For the T1N0M0 SCCP patients treated in the community, RT was associated with nearly a twofold higher CSM than PP. Ideally, a validation study based on tertiary care institution data should be conducted to test whether this CSM disadvantage is operational only in the community or not.© 2024. Society of Surgical Oncology.