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材T`~Fだ戳

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材き`龟喷のgu厩浪d

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材@`yf厩

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材G`of诀Pfz

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材T`~Fだ戳

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材@戳G砾F度IデtYの]ブ

材G戳G砾FIデ潮掺DF

材T戳Giち埃浮肪Oぺ挡锣簿

材|戳G砾FIデ潮掺Fぇ~ALkち埃浮肪Oぺ挡锣簿A┪环B锣

~tΤTNMだ戳kp3-1C

3-1.潮掺砾ぇだ戳（InternationalUnionAgainstCancerSystem）[v]

Primarytumor（T）

Noevidenceofprimarytumor

Carcinomainsitu

Noninvasiveverrucouscarcinoma

Tumorinvadessubepithelialconnectivetissue

Tumorinvadesthecorpusspongiosumorcavernosum

Tumorinvadestheurethraorprostate

Tumorinvadesotheradjacentstructures

Regionallymphnodes（N）

Noregionallymphnodemetastasis

Metastasisinasinglesuperficialinguinallymphnode

Metastasisinmultipleorbilateralsuperficialinguinallymphnodes

Metastasisindeepinguinalorpelviclymphnode（s）,unilateralorbilateral

Distantmetastasis

Nodistantmetastasis

Distantmetastasis

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材き`龟喷のgu厩浪d

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潮掺场ち埃N

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潮掺ち埃N

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Ы场Oぺ挡Bm

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@H癸H潮掺ち埃ㄓv励潮掺砾A`OKぃF|ΤU贺{みz承端（psychologicaltrauma）C]Τ\h沽刚Od潮掺\v励よΑA]Aguv励单CΤ@兜jso{AHもNち埃潮掺┪Oguv励AㄓBzof_（primarytumor）Aㄤv励挡GSΤぃP[x],[xi]C埃F砰~gu酚gAg┦v-192妮u从J（Iridium-192wireimplant）AGiㄏ┮Τv励fHO┦\[xii]A]O@贺匡拒Cguv励]ノ秆埃gAㄒpGkhAX┪溃┦g单C

Y~F┪Ы场Oぺ挡びjAiH@ō┦て厩v励AYpY{AAち埃もNCY~Fw憨┑ōAhiσ{@ō┦て厩v励A`ノて厩媚Cb7-1C潮掺砾癸て厩v励は莱v（responserate）b3050%ぇ丁A@ㄓ弧Aぶǎ戳w秆（long-termremission）C

7-1.潮掺砾`ノ虫@て厩v励媚の励

95%H苦跋丁

[xiii]A[xiv]

Methotrexate

[xv]A[xvi]

[xvii]A[xviii]

潮掺砾w

潮掺砾wMㄤ~FIデ{Τj闽CYSΤOぺ挡锣簿Ah5~svΤ65%90%CYIデOぺ挡Ah度Τ3050%ぇ5~svCYwIデz癌Oぺ挡hC20%AYΤㄤL竟x┪癌f锣簿A@fHぃ|L5~C

xj洛|q19761995~A@20~丁Av励F97潮掺砾ぇfㄒAㄤキА~闹57.6∮16.7烦Cㄤい88gfz厩TwAㄤい79Hil萝ㄤspA材@の材G戳（Ν戳）fH@57A]潮掺砾`度Τ2HAs戳い计|ゼFC材Tの材|戳fH@22A`Τ9HAs戳い计57るAPΝ戳fHぇs戳Τ陪参pWぇt钵[xix]（瓜7-1）C

[1].い地チ瓣F|矫ネp砾gnO厨iAチ瓣69~82~C

2.CatalonaWJ:Modifiedinguinallymphadenectomyforcarcinomaofthepeniswithpreservationofsaphenousveins:Techniqueandpreliminaryresults.JUrol1988;140:306.

3.MikhailGR:Cancers,precancersandpseudocancerofthemalegenitalia:Areviewofclinicalappearances,histopathology,andmanagement.JDermatolSurgOncol1980;6:1027.

4.JacksonSM:Thetreatmentofcarcinomaofthepenis.BrJSurg1966;53:33-5.

5.HermanekP,SobinLH,eds.TNMclassificationofmalignanttumors.4thed.Geneva:InternationalUnionAgainstCancer（UICC）,1987:130-2.

6KossowJH,HotchkissAS,MoralesPA:Carcinomaofthepenistreatedsurgically:Analysisof100cases.Urology1973;2:169.

7.JacksonSM:Thetreatmentofcarcinomaofthepenis.BrJSurg1966;53:33.

8.CabanasRM:Anapproachforthetreatmentofpenilecarcinoma.Cancer1977;39:456.

9.CatalonaWJ:Modifiedinguinallymphadenectomyforcarcinomaofthepeniswithpreservationofsaphenousveins:Techniqueandpreliminaryresults.JUrol1988;140:306.

10.HorenblasS,vanTinternH:Squamouscellcarcinomaofthepenis.IV.Prognosticfactorsofsurvival:analysisoftumor,nodesandmetastatsisclassificationsystem.JUrol1994;151:1239-1243.

11.MazeronJJ,LangloisD,LoboPA,etal:Interstitialradiationtherapyforcarcinomaofthepenisusingiridium192wires:theHenriMondorexperience（1970-1979）

12.DelannesM,MalavaudB,DouchezJ,atal:Iridium-192interstitialtherapyforsquamouscellcarcinomaofthepenis.IntJRadiatOncolBiolPhys1992;24:479-83.

13.GanglianoRG,BlumensteinBA,CrawfordED,etal:Cis-diaminedichloroplatinuminthetreatmentofadvancedepidermoidcarcinomaofthepenis:aSouthwestOncologyGroupstudy.JUrol1989;141:66-7.

14.SklaroffRB,YagodaA:Cis-DiaminedichlorideplatinumII（DDP）inthetreatmentofpenilecarcinoma.Cancer1979;44:1563-5.

15.SklaroffRB,YagodaA:Methotrexateinthetreatmentofpenilecarcinoma.Cancer1980;45:214-6.

16.GarnickMB,SkarinAT,SteeleJrGD:Metastaticcarcinomaofthepenis:completeremissionafterhigh-dosemethotrexatechemotherapy.JUrol1979;122:265.

17.IchikawaT,NakanoI,HirokawaI:Bleomycintreatmentofthetumorsofpenisandscrotum.JUrol1969;102:699-707.

18.KylwaziSK,BhamsD,HarrisonNWW:CarcinomaofthepenisandbleomycinchemotherapyinUganda.BrJUrol1974;46:689-96.

19.xj洛|f菌砾gnOp舱戈A1976-1995C

瓜1-1xWa跋潮掺のㄤLk┦ネ崔竟x砾gC~E_H计（F|矫ネp参p戈）C

瓜1-2xWa跋潮掺砾ぇof~闹だG瓜（F|矫ネp参p戈）C

瓜2-1iゅんf（Bowenˉsdisease）A@贺キ灿M砾（squamouscellcarcinoma）砾C

瓜2-2潮掺キ灿M砾CbYà借て（keratinization）场C

瓜2-3潮掺砾C~FDntYB环狠]ブの潮掺FC

瓜7-1xj洛|Ν戳の边戳潮掺砾fHぇspゑ耕（Kaplan-Meierplot）CㄢsfHぇs戳Τ陪参pWぇt钵（Log-ranktest）C