膀胱癌と前立腺癌の重複癌についての臨床的検討

Abstract

男性前立腺癌・膀胱癌の重複患者(男性膀胱癌患者の5.7%, 前立腺癌患者の4.1%)に対する臨床的検討を行った.対象は17名で, 第1癌と第2癌の発生の間隔は平均45.3ヵ月であった.二つの癌の発生間隔が1年以上の異時性は9例で, 膀胱癌先行5例に比べ, 前立腺癌先行4例は診断時の平均年齢は高く, 第1癌(前立腺癌)と第2癌(膀胱癌)発生の間隔も短かった.二つの癌の発生間隔が1年以内の同時発生8例では, 3例が膀胱全摘時に偶然前立腺癌が発見された.Follw up期間は平均84.7ヵ月で, 癌死は2例(前立腺癌, 膀胱癌各1例)であった.第1癌発見後も, その癌の再発にとらわれることなく第2癌の早期発見に努めるべきであり, 二重癌を治療する際, どちらがadvanceかということを優先して治療を展開していく必要があると思われた

Between January 1989 and March 2002, we treated 299 male bladder cancer patients and 416 prostatic cancer patients. Of these, 17 patients (5.7% of the male bladder cancer patients and 4.1% of the prostatic cancer patients) had double cancer consisting of prostatic cancer and bladder cancer. The mean age at diagnosis of the first and second cancer was 71.6 years and 75.5 years, respectively. Of the 8 patients with synchronous tumors, 3 patients had latent prostate cancer when they underwent total cystoprostatectomy. The mean interval between the first and second cancer was 45.3 months. The mean follow-up period was 84.7 months (ranged from 5 to 324 months) and two patients died of cancer (bladder: 1, prostate: 1). In the literature, the coincidence of bladder cancer and prostatic cancer is the highest in the urological field. In follow up of either of these cancer patients, it is important to be aware of not only progression of the first cancer but also generation of a second cancer.