膀胱癌の臨床的観察 : 各年齢別の臨床像の特徴について

Abstract

原発性膀胱癌患者394例を対象として, 年齢群別に, 各群の臨床像を比較検討した。1)主訴は血尿が最も多く, 全群間で差はなかったが, 若年者では主訴発現から受診までの期間が長かった。2)高齢者群に多発性で大きな腫瘍が発生する傾向が認められた。3)高齢者群にhigh gradeでhigh stageの腫瘍の発生する頻度が高かった。4)TUR-BT後の5年非再発率は高齢者とくに80歳以上で有意に低かった。5)5年生存率は高齢者で有意に低かったが, 膀胱全摘除術後の5年生存率には有意差は認められなかった

Three hundred and ninety-four patients with transitional cell carcinoma of the bladder who initially visited Yokohama City University Hospital were reviewed according to age group. The patients were divided into four groups, group A (less than 49 years old), group B (from 50 to 64 years old), group C (from 65 to 79 years old) and group D (more than 80 years old). The clinical characteristics as follows were obtained by statistical analysis compared with these four groups. No statistical significance was obtained about frequency of macroscopic hematuria as chief complaint. However, the younger age groups (A and B) tended to visit hospital later after the first symptom of hematuria. The older age groups (C and D) had multiple and large tumor at the first cystoscopic examination. The older age groups (C and D) had high stage and high grade tumor at the first roentgenological examination and transurethral biopsy or resection. The 5-year recurrence free rate after transurethral resection of bladder tumor (TUR-BT) of the older age group (D group) was lower than that of the other groups. The 5-year survival rate of older age group was lower than that of the younger age group. However, no statistical significance between the age groups existed concerning high grade or high stage tumor and survival after total cystectomy. We clarified here that the clinical features of elderly patients who have bladder cancer were significantly different from those of younger patients. Otherwise the prognosis of patients who have high grade and/or high stage bladder cancer were demonstrated to be poor regardless of age.(ABSTRACT TRUNCATED AT 250 WORDS)