腎盂尿管腫瘍の臨床的研究

Abstract

We report on 54 patients with urothelial tumors in the upper urinary tract who were admitted to either of our hospitals between April 1961 and October 1980. The patients consisted of 37 males and 17 females; their ages ranged from 23 to 80 years with a mean of 58.3 years. Macro- or micro-hematuria was observed in over 80% of the patients. Pathologically, 51 of the patients had transitional cell carcinoma and 1 had squamous cell carcinoma. The actual five-year survival rates for all the patients was 39.1 %, the prognosis being influenced significantly by the stage and grade of the tumor, which were closely related to each other. But statistically, the survival rate was more closely correlated to the stage of the tumor than the grade. Nephrectomy or nephro-ureterectomy with or without partial cystectomy was performed on most of the patients. The survival period seemed to be shortened when only nephrectomy was performed. The patients who received nephro-ureterectomy had postoperative survival rates similar to those who received nephro-ureterectomy with partial cystectomy, but both of these methods were better than nephrectomy alone. Autopsy made on 7 patients showed clear tumor recurrence in the retroperitoneal space. Therefore, prevention of local recurrence seems to be important in improving the prognosis of upper urotbelial tumors.