High gradeの膀胱癌の治療成績

Abstract

1)High gradeの膀胱癌患者は全膀胱癌患者の約32%を占め, それらの腫瘍の83%はstage T2以上の浸潤癌であった.2) High grade患者では尿細胞診は88%に陽性であった.3) High grade患者128例の全体の5年生存率は32%であり, stage別では, T1症例64.2%, T2症例55.6%, T3症例22.7%, T4症例8%であった.4) High grade症例の治療法別の予後の検討ではT3以下のstageで膀胱全摘出術がTURや部分切除などの保存的治療に比して明らかに良好な成績であった.5) high gradeの膀胱癌は浸潤癌になりやすく, 予後不良であり, 治療法としては膀胱全摘出術を中心とした積極的治療法が望ましい

The prognosis and other clinical manifestation of 128 patients with high grade bladder tumor were analyzed. Thirty two percent of the total cases of bladder cancer were high grade bladder cancer and 83% of their tumors were invasive tumor at stage T2 and worse. Urinary cytologies were positive in 88% of these patients. The 5-year survival rate in these patients was 32% and those in T1, T2 T3 and T4 cases were 64.2%, 55.6%, 22.7% and 8.0% respectively. The patients treated with radical (total) cystectomy showed a much better survival rate than the cases treated with TUR or partial cystectomy. These results suggest that high grade bladder cancers tend to be invasive and the patients with high grade bladder cancer would have a poorer prognosis than the patients with other histological grade tumors. Thus, these patients should be treated more aggressively including radical cystectomy than the other cases of bladder cancers.