腎盂尿管腫瘍の臨床的観察

Abstract

1)入院加療を行った腎盂尿管腫瘍66例について検討した.2)発生部位は腎盂27例, 尿管31例, 腎盂尿管8例であった.3)発症年齢は43歳から86歳(平均年齢65歳)で, 性別は男性46例, 女性20例であった.4) DIP所見では無機能腎を呈した症例が54.1%と最も多かった.5)尿細胞診陽性例はhigh gradeが多かった.6)組織型は移行上皮癌60例, 扁平上皮癌2例, 両者の混合型が4例であった.7)膀胱腫瘍の合併は, 先行性6例, 同時性8例, 続発性13例であった.8)全体の生存率は1年生存率80%, 3年生存率68%, 5年生存率52%であった.9)所属リンパ節あるいは遠隔転移を有する症例の予後は非常に不良であった.10)各予後因子の検討では, 組織学的深達度が最もよく予後を反映していた

Sixty-six patients with renal pelvic and ureteral tumors were treated in our hospital between June 1974 and June 1991. These cases consisted of 27 renal pelvic tumors, 31 ureteral tumors and 8 renal pelvic and ureteral tumors. Their ages ranged from 43 to 86 years old (average: 65). There were 46 males and 20 females. The surgical method involved total nephroureterectomy with a cuff for 44 patients, nephroureterectomy for 3, nephrectomy for 9, total nephroureterectomy with total cystectomy for 5 and partial ureterectomy for 2. Histologically, there were 60 transitional cell carcinomas (TCC), 2 squamous cell carcinomas (SCC) and 4 TCC with SCC. As for the pathological stage, 13 were pTa, 16 pT1, 12 pT2, 11 pT3, 13 pT4 and 1 pTX. Subsequent bladder tumors were found in 13 patients (19.7%). The overall survival rate at 1, 3 and 5 years were 80%, 68% and 52%, respectively according to the Kaplan-Meier's method. In this series, the pathological staging was the most important prognostic factor.