膀胱全摘除術をおこなった膀胱癌症例の治療成績

Abstract

'70年から'89年に膀胱癌の全摘出を施行した93例(男性71例, 36-87歳, 平均67歳)の転帰を報告した。全体の生存率は5年と10年でそれぞれ51.36%であった。グレード2と3の5年生存率はそれぞれ72.44%であった。病理ステージpT0-1, pT2, pT3, pT4aの5年生存率はそれぞれ66, 51, 35, 44%であった。pT0-1とpT3間には有意差があった。pT4aN0では生存率が67%と高かった。リンパ腺陽性と陰性の5年生存率はそれぞれ54.22%であった。術前照射の効果は説明できなかったが, 照射と化学療法の併用は生存率を向上させた。尿道切除同時施行例は無施行例より生存率が高かった

We assessed the treatment outcome of total cystectomy for 93 patients (71 men and 22 women) with bladder cancer treated in the Public Toyooka Hospital from 1970 to 1989. Patient age varied from 36 to 87 (mean 67). The overall actuarial survival rates at 5 and 10 years were 51% and 36%, respectively. The 5-year survival rates were 72% for grade 2 and 44% for grade 3 disease. The 5-year survival rates according to the pathological stage were 66% for pT0-1, 51% for pT2, 35% for pT3, 44% for pT4a disease. A statistical difference was noted between the 5-year survival rate of patients with pT0-2 disease and that with pT3. Patients with pT4aN0 disease showed a relatively high survival rate (67%). The 5-year survival rates were 54% for the patients with negative lymph node and 22% for those with positive lymph node. Although we could not demonstrate the efficacy of preoperative radiotherapy, the combination of radiation and chemotherapy was suggested to improve the survival after cystectomy. Patients who received simultaneous urethrectomy showed a higher 5-year survival rate as compared to those who did not.