217例膀胱移行细胞癌外科治疗的临床分析  

Surgical Treatment for 217 Patients with Bladder Transitional Carcinoma

作　　者：余绍龙[1] 周芳坚[1] 秦自科[1] 韩辉[1] 刘卓炜[1] 王斌[1] 王欢[1] 李永红[1] 

机构地区：[1]华南肿瘤学国家重点实验室

出　　处：《癌症》2006年第1期73-75,共3页Chinese Journal of Cancer

摘　　要：背景与目的:膀胱移行细胞癌(transitionalcellcarcinoma,TCC)是泌尿系统常见肿瘤,手术切除是其主要治疗手段。本研究旨在探讨TCC的外科治疗方法及其临床效果。方法:对217例采用不同术式治疗的TCC术后无瘤生存、复发和死亡患者的临床资料进行回顾性分析和总结。结果:随访时间平均30个月,全组患者无瘤生存195例,复发56例次;死亡14例,其中非肿瘤死亡1例,肿瘤死亡13例。T1期或Ⅰ级肿瘤患者无死亡。全组患者2年总生存率为89.6%。患者生存率及无瘤生存率与肿瘤分期、分级呈负相关。T1期和T4期肿瘤患者预后与术式无关。对T2期和T3期肿瘤,根治性膀胱切除者的预后比保留膀胱者的预后好,两者比较具有显著性差异,P<0.01。结论:对分期早、高分化的TCC患者采用保留膀胱的治疗措施是安全的;分期晚、低分化的浸润性TCC患者应及时行根治性膀胱切除。BACKGROUND ＆ OBJECTIVE： Bladder transitional cell carcinoma （TCC） is the most common cancer among urogenital neoplasms. Surgical operation is the most effective therapy for TCC. This study was to explore surgical treatment for TCC and its clinical significance. METHODS： Clinical data, including disease-free survival, recurrence and death, of 217 TCC patients who had received different surgical procedures were retrospectively analyzed. RESULT： After a median follow-up of 30 months, 195 patients were free of disease, recurrence was observed for 56 times. Fourteen patients died. 13 of them died of progressive disease, and 1 died of renal failure. None death occurred in patients with stage T1 or grade I tumor. The overall 2-year survival rate was 89.6%. The survival rate and disease-freely survival rate were negatively correlated to stage and grade of the tumors. The prognosis of stage T1 and T4 patients had no correlation to surgical procedures. For stage T2 and T3 tumors, the prognosis of the patients who received radical cystectomy was significantly better than that of the patients who received organ sparing procedure. CONCLUSIONS： The organ sparing treatment is safe for patients with early stage and well differentiated TCC. Radical cystectomy should be done in time for patients with advanced and poorly differentiated TCC.

关 键 词：膀胱肿瘤/外科手术 癌 移行性细胞 复发 预后 

分 类 号：R737.14[医药卫生—肿瘤]