Ta Grade 1又は2膀胱癌の再発と進展に関する臨床的検討

Abstract

Ta G1又はG2の膀胱移行上皮癌107例を対象に, その再発と進展, T1へのstage-upとG3へのgrade-upについて検討した. 1)5年及び10年非再発率は47.3%, 29.8%であり, 腫瘍径1cm以上の群で有意に再発しやすかった. 2)5年及び10年非進展率は93.3%であり, 広基性腫瘍の群で有意に進展しやすかった. 3)T1へのstage-upを13例(12%)に, G3へのgrade-upを7例(6.5%)に認めたが, T1へのstage-upのみでは進展の危険因子とはいえず, 一方, G3へのgrade-upは進展の危険因子であった. 4)G3へのgrade-upの危険因子はG2腫瘍であった

We treated 107 new patients with stage Ta, grades 1 and 2 transitional cell bladder carcinoma by transurethral resection during the past 23 years. The clinicopathological factors evaluated were grade, size, number and form of tumor. Fifty-five patients (51%) had recurrent tumors after initial resection and progression (muscle invasion or metastasis) occurred in four patients (3.7%). The 5-year and 10-year recurrence free rates were 47.3 and 29.8%, respectively. Seven patients (6.5%) had grade 3 tumor (grade-up) at recurrence. An increase in T category to T1 (stage-up) occurred in 13 patients (12%), only one of whom later developed an invasive tumor (pT4). The size of tumor significantly affected the rate of recurrence (p < 0.01). Sessile tumor were at a significantly greater risk for progression (p < 0.05). Stage-up did not have a significant effect on progression, but grade-up was significantly risky for progression (p < 0.01). Initial grade 2 tumors were highly related to grade-up (p < 0.05).