腎盂尿管腫瘍の臨床的検討

Abstract

1)年齢は, 44歳から80歳で平均67.4歳で男性30例, 女性5例であった。2)部位では, 尿管15例, 腎盂15例, 腎盂+尿管3例, 尿管+膀胱2例であった。3)病理組織型では, 移行上皮癌30例, 扁平上皮癌1例, 移行上皮癌と扁平上皮癌との合併2例, 乳頭状腺癌1例であった。4) 5年生存率は全体で44.9%, Stage別ではlow stage群とhigh stage群を比較すると5年生存率は76.7%と24.9%, Grade別では, G1, G2, G3それぞれの5年生存率は83.3%, 59.2%, 0%, 脈管侵襲のないものと有るもので比較すると5年生存率は68.7%と20.8%であった。予後は, 深達度, 異型度, 脈管侵襲の有無と相関していた

Thirty five patients with renal pelvic and ureteral tumors were treated at our hospital between 1979 and December 1992. Thirty patients were male and five were female. They ranged in age from 44 to 80 years old (average 67.4 years). The most frequent symptoms were hematuria that was found in 31 cases (24 gross hematuria and 7 microscopic hematuria). Histopathologically, there were 30 transitional cell carcinomas (TCC), 1 squamous cell carcinoma (SCC), 2 TCC > SCC and 1 papillary adenocarcinoma. As to staging, 1 was pTis, 5pTa, 11pT1, 3pT2, 11pT3 and 4pT4. As to grading, 9 were G1, 16 G2 and 9 G3. The incidence of cancerous vessel invasion was noted in 8 of the 29 patients. The 5-year survival rate (Kaplan-Meier's method) was 44.9% for all of the patients. The 5-year survival rate according to staging and according to grading were as follows: 76.7% for low stage (pTis, pTa, pT1, pT2), 24.9% for high stage (pT3, pT4), and 83.3% for G1, 59.9% for G2 and 0% for G3. The 5-year survival rate was 20.8% and 68.7% in the patients with and without vessel invasion, respectively. Grade, stage and cancerous vessel invasion was suggested to be associated with the prognosis in renal pelvic and ureteral tumors.