右尿管癌の膀胱浸潤症例(cT4N1M0) に対して, 術前化学療法(MVEC) が奏効した1例

Abstract

Poorly differentiated ureteral cancer has a poor prognosis, and tumor recurrence is frequent even after nephroureterectomy. We performed neoadjuvant chemotherapy to prevent postoperative recurrence. A 74-year-old man was diagnosed with ureteral cancer (3 cm) by magnetic resonance imaging (MRI). The clinical stage was T4N1M0. Histological examination by transurethral biopsy revealed an urothelial carcinoma, G3, pT1. After a month, the tumor size increased from 3.0 cm to 4.0 cm. With two cycles of neoadjuvant chemotherapy consisting of methotrexate, vinblastine, epirubicin and cisplatin (MVEC) partial remission (regression rate : 87%) was achieved, Following MVEC, right retroperitoneoscopy-assisted nephroureterectomy, total cystectomy, and ileal conduit were performed. Pathological stage was pT0. After two years, postoperative recurrence has not appeared.