腎盂尿管腫瘍のリンパ節転移に関する検討

Abstract

1)腎盂尿管腫瘍38例についてリンパ節転移を中心に検討した。2)リンパ節転移は9例, リンパ節転移のrisk factorはhigh grade, high stage, 尿細胞診class 4・5の症例であり, 尿細胞診のみ有意差を認めた。3)膀胱腫瘍の先行, 併発例は7例で, そのうち6例がG3であるのに対し続発例は7例でそのうち5例はG2であった。4)5年生存率はリンパ節転移陰性例76.7%, 陽性例11.1%で両者に有意差を認めた。5)腎盂尿管腫瘍におけるリンパ節転移の治療的意義については評価できなかった

A clinical study was performed on 38 patients with renal pelvic and ureteral cancers who were treated in our hospital between 1977 and 1992. Nine patients (23.7%) had lymph node metastasis. The risk factors of lymph node metastasis were high grade, high stage and class IV or V or urine cytology. None of the patients with G1 or under pT1 had lymph node metastasis. The 5-year survival rate of the patients without [lymph node metastasis was 76.7% and that of the patients with lymph node metastasis was 11.1%. Although 6 of the 9 patients with G1 or G2 and under pT1 did not have adjuvant therapy, none of them died of the cancer. We concluded that lymph node metastasis in renal pelvic and ureteral cancers was the most important prognostic factor and that regional lymphadenectomy might be useful for the decision of adjuvant therapy.