当教室における過去10年間の上部尿路癌に関する臨床的検討

Abstract

10年間に経験した上部尿路癌は腎癌29例, 腎盂癌14例, 尿管癌9例の計52例で, これらについて臨床統計学的検討をおこなった.1)腎癌, 腎盂癌, 尿管癌はともに男子例に多い傾向をみとめた.左右差はとくにみとめなかった.2)腎癌の好発年齢は40歳代に比し, 腎盂癌は70歳代, 尿管癌は60歳代と, 腎癌のほうが若年齢層に多くみとめられた.3)初発症状はいずれも肉眼的血尿がもっとも多かったが, 腎癌の42%にたいし腎盂・尿管癌は60%と, 後者のほうが高頻度であった.4)腎癌と尿管癌の5年生存率が68%, 80%であるのにたいし腎盂癌は37%と予後不良であった.5)腎癌・腎盂癌・尿管癌の高深達度群は低深達度群に比し5年予後は不良であった.6)腎癌では初発症状発生より手術までの期間が短いほど, 予後は良い傾向であったが, 腎盂・尿管癌ではむしろ短いほど予後不良という傾向であった.7)腎癌では女子のほうが男子に比し予後が良い傾向であった.8)腎癌の摘出腎重量が大きいほど, 予後不良であった.9)腎癌の低深達度群においては治療法と予後との間にはあきらかな関連性をみとめなかった

A clinical survey was done on 52 patients with carcinoma of the upper urinary tract (29 renal carcinomas, 14 renal pelvic carcinomas and 9 ureteral carcinomas) treated in our Department during the recent 10 years (l970~1979). Renal, pelvic and ureteral carcinoma occurred more in males than in females. The age groups in which renal, pelvic and ureteral carcinoma were seen most frequently were the 40s, 70s and 60s, respectively. The most frequent primary symptom in these three carcinomas was gross hematuria. The 5-year survival rate of renal carcinoma and ureteral carcinoma were 68 and 80 %, respectively, while that of pelvic carcinoma was 37%. For all 3 kinds of carcinomas, the prognosis of patients with high stage cancer was significantly worse than that of patients with low stage cancer. The prognosis of the group of patients with renal carcinoma undergoing operations within 3 months was better than that of the patients undergoing operations after 3 months from the onset of primary symptoms. However, the reverse was the case for patients with pelvic or ureteral carcinoma. In renal carcinoma, the prognosis of female patients was better than that of male patients. In renal carcinoma, the prognosis of patients with a heavier kidney removed was significantly worse than that of the patients with a lighter kidney removed. There was no apparent relationship between the method of therapy and the prognosis of patients with low stage renal carcinoma.