上尿路尿路上皮肿瘤患者术后应早期预防性膀胱灌注  

Patients with upper tract urothelial carcinoma should receive early prophylactic intravesical chemotherapy after nephroureterectomy

作　　者：袁传威 陈友根[1] 兰晓鹏 卢国良[1] 毛少为 于江[1] 夏庆华[1] 

机构地区：[1]山东大学附属省立医院泌尿微创中心,山东济南250021

出　　处：《现代泌尿外科杂志》2015年第8期592-595,共4页Journal of Modern Urology

基　　金：山东省医药卫生科技发展计划(No.2014WS0351)

摘　　要：根治性肾、输尿管切除及膀胱袖状切除术是上尿路尿路上皮肿瘤（UTUC）的标准术式。可能是因为瘤细胞种植和区域化癌变的缘故,约22%~47%的患者术后继发膀胱肿瘤。为阐明预防性膀胱灌注化疗在预防膀胱肿瘤复发中的作用,实施了多个前瞻性随机临床试验,发现术后THP或MMC膀胱灌注可显著降低其复发率,术后早期应用且安全可行。因此,我们建议UTUC术后应预防性膀胱灌注,但最佳方案尚需研究。The standard management of upper tract urothelial carcinoma （UTUC） was radical nephroureterectomy with bladder cuff excision, however, approximately 22%-47% of them develop subsequent bladder tumour recurrence, potentially because of the implantation of cancer ceils and field cancerization. To elucidate the effect of prophylactic intravesical chemotherapy in preventting bladder recurrence, several prospective randomized phase II studies were conducted. A significant decrease in bladder recurrence after surgery was observed in the intravesical instillation by THP or MMC. Early prophylactic intravesical chemotherapy is also effective and safe for the prevention of bladder recurrence after radical nephroureterectomy. Therefore, we suggest that prophylactic intravesical chemotherapy should be performed in patients with UTUC after radical nephroureterectomy, but the optimal regimen should be explored in future.

关 键 词：膀胱复发 膀胱灌注 肾、输尿管切除术 上尿路尿路上皮肿瘤 

分 类 号：R737.4[医药卫生—肿瘤]