最近10年間の上部尿路悪性腫瘍の臨床的検討

Abstract

1)1976年から10年間に腎腫瘍50例, 腎盂腫瘍25例, 尿管腫瘍32例を経験した.2)好発年齢は腎腫瘍は50～60歳代, 腎盂・尿管腫瘍60～70歳代, いずれの腫瘍も男に多く, 腎腫瘍は左右同数で, 腎盂・尿管腫瘍はやや左側に多かった.3)初発症状は, 肉眼的血尿が最も多かったが, 腎盂・尿管腫瘍においては腎腫瘍よりも高頻度であった.4)組織型は, 腎腫瘍ではclear cell typeが最も多く, 腎盂・尿管腫瘍では移行上皮癌が大半を占めていた.5)実測5年生存率は, 腎腫瘍48.1%, 腎盂腫瘍37.9%, 尿管腫瘍31.8%であった.6)いずれの腫瘍も, high grade, high stageの群はlow grade, low stageの群に比して予後不良であった.7)上部尿路悪性腫瘍における赤沈値, 腎腫瘍における摘出重量, 腎盂・尿管腫瘍における尿細胞診, DIP所見などは, 予後を占うパラメーターとなり得る

A clinical survey was done on 107 patients with malignant tumor of the upper urinary tract (50 renal tumors, 25 renal pelvic tumors, 32 ureteral tumors) treated at our Department during the last 10 years (1976-1985). All types of tumors occurred more frequently in males than in females. The age groups of patients in which renal, renal pelvic and ureteral tumors were seen most frequently were those in their sixties, sixties and seventies, respectively. The most frequent primary symptom in patients with these three tumors was gross hematuria. The 5-year actual survival rate for the patients with renal, renal pelvic and ureteral tumors was 48.1, 37.9 and 31.8%, respectively. For all 3 kinds of tumors, the prognosis of patients with high-grade and high-stage cancer was worse than that of patients with low-grade and low-stage cancer. One-hour erythrocyte sedimentation rate for all the tumor types, weight of resected kidney in the case of renal tumor, and the class of urinary cytology and drip infusion pyelography findings in the case of renal pelvic and ureteral tumors were considered to be the factors possible influencing prognosis.