Low gradeの表在性膀胱癌の治療成績

Abstract

1970年以降11年間の膀胱癌207例中Low grade, low stageものは男50, 女7例で, 再発腫瘍はその57例中27例に認められ, 治療法別5年累積再発率は経尿道的電気凝固術(TUC-Bt) 88%, 粘膜下腫瘍切除術75%, 膀胱部分切除術50%, 経尿道的切除術(TUC-Bt) 63%であった.再発予防のため, TUC-Bt後に制癌剤の膀胱内注入療法を行ない, 5年累積再発率は, 注入群は35.4%対照とした非注入群では63%であった.多発腫瘍症例の再発予防法として, TUC-Bt後に膀胱内温熱療法を施行し, 5年累積再発率は25%と良好であった.なお, 再発腫瘍の5例にgrade 1よりgrade 2への変化を認めたが, grade 3へ変化した症例はなかった

Fifty-seven patients with low-grade and low-stage urinary bladder cancer were treated at our University Hospital between 1970 and 1980. The incidence of low grade and low stage cases was higher in the young group than in the older group, and in male than in female (p less than 0.05). Most of the patients were well-controlled by either TUR or other conservative therapies. The 5-year relative survival rate was 113%. The 5-year actual cumulative recurrence rate after TUR was 63%, whereas, the 5-year actual cumulative recurrence rate was only 35.4% in those who received intravesical instillation therapy and 25% in those who undergone RCH (Radio-Chemo-Hyperthermia) therapy. Five patients (9%) showed an increase of tumor grade from low to intermediate at the time of intravesical recurrence, but no patient showed a change from low to high grade.