腎盂尿管癌の臨床的検討

Abstract

1983年10月～1995年6月迄に福井医科大学において治療した腎盂尿管癌40例に関して臨床的検討を行った.平均年齢は65歳, 男女比は1.5であった. 1)組織型は全例移行上皮癌で, 深達度では壁内浸潤(pT1とpT2)を12例, 壁外浸潤(pT3とpT4)を19例に認めた.リンパ節転移は12例に, 遠隔転移は4例に認められた. 2)腎盂・尿管壁内脈管侵襲としてリンパ管侵襲を63%に, 静脈侵襲を46%に認め, その頻度は深達度, 異型度と関連した. 3)膀胱癌の併発を21例に認めた. 4)全症例での5年生存率は57.1%で, 深達度, 脈管侵襲が予後と有意に関連していた

We reviewed 40 patients with renal pelvic and/or ureteral transitional cell carcinomas, consisting of 24 males and 16 females with a mean age of 65 years. The histopathological stage of surgically removed specimen was pTa in 6 patients, pT1 in 7, pT2 in 5, pT3 in 11 and pT4 in 6. Three patients with Tis and 2 with T3 did not undergo surgery. Of 35 patients pathologically examined, lymphatic and venous invasions were detected in 22 (63%) and 16 (46%), respectively, and were associated with pathological stage and grade. Overall the 5-year actuarial survival rate was 57.1%. Tumor staging and vascular invasion had a prognostic significance on the treatment outcome, but not metachronous or synchronous bladder cancer, identified in 55% of the patients. Adjuvant chemotherapy appeared to improve the survival of the patients with tumors pT2 or higher, grade 3 or vascular invasion without metastases.