泌尿器癌を有する高齢患者の治療

Abstract

1)当科における泌尿器癌患者の約10%は80歳以上の高齢者であり, 特に前立腺癌と膀胱癌でその占める割合が高かった。2)標準的な治療と実際に行われた治療の一致率は膀胱癌では表在性膀胱癌で, 前立腺癌では進行癌で高くなっていた。3)退院後も外来に通院したものは22%と少なく, 予後は確認された41例中の18例が生存, 23例が死亡し, 5年生存率は40.6%であった。4)治療を要する併発症は循環器系を中心として, 80%の症例で認められた

The number of elderly patients with urological cancer is increasing, and it is becoming very difficult for urologists to decide on an appropriate treatment modality for each patient. Physical and socioeconomical problems make it impossible for the patients to accept a standard treatment for their disease. Between 1987 and 1992, 498 patients with urological cancer were hospitalized in our institute. Among them, 51 patients (10%) were 80 years of age or older. The average age of these older patients was 83.2 (80-93) years. There were 41 men, and 10 women. These older patients included 30 with bladder cancer, 15 with prostate cancer, three with renal cancer, and three with renal pelvic and ureteral cancer. The incidence of patients aged 80 or older was 18.5% for prostate cancer and 15.9% for bladder cancer. Eighty percent of these patients had complications such as cardiovascular disease, and fewer patients could be adapted treatment because of their physical condition. The median survival period was 21.6 months, with only 18 of the patients still living at the time of the analysis. Only 11 of the initial 51 patients (22%) still received follow-up treatment in the outpatient clinic of our institute, 10 of whom were lost during the follow-up. Our observations indicate that we should consider both the medical aspects and quality of life when we choose the suitable type of treatment.