膀胱腫瘍を併発した腎盂尿管腫瘍の臨床的検討

Abstract

1)腎盂尿管腫瘍の異型度, 深達度, リンパ管・脈管浸潤, INFより膀胱腫瘍の続発を予想することは困難であり, 全ての症例において2～3年間は尿細胞診, 膀胱鏡による定期的観察が必要である. 2)腎盂尿管腫瘍の予後に影響を及ぼす因子としては, 異型度と深達度が最重要であり, 膀胱腫瘍の未発生・併発(同時併発・続発)は予後に影響を及ぼさないと考えられる

We reviewed 45 cases of transitional cell carcinoma of the renal pelvis and ureter with reference to the coexistence or subsequent development of bladder cancer. Bladder cancer was associated with an upper urinary tract neoplasm in 26 of the 45 cases. The 5-year survival rate for coexistence of bladder cancer was 56% and that for subsequent bladder cancer was 65.6%. The 5-year survival rate for 19 cases unrelated with bladder cancer was 46.7%. Therefore, there was no significant difference among the three groups. As to degree of the malignancy of the renal pelvis and ureter, the 5-year survival rate was 73.7% for G1 and G2 and 26.2% for G3. As to the depth of invasion, of the renal pelvis and ureter the 5-year survival rate was 71.8% and 31.1% in the patients with stage of T1, T2 and T3, T4. The prognosis of cancer of the upper urinary tract depended on the degree of the malignancy, and the depth of invasion. Ninety two percent of subsequent bladder cancer was detected within 2 years after resection of the primary cancer.