手术后脐尿管癌的治疗及预后分析  

Analysis of treatment and prognosis in post-operative patients with urachal carcinoma

作　　者：牛海涛[1] 董平[2] 王佳妮[1] 黄镜[1] 曾益新[1] 

机构地区：[1]中国医学科学院肿瘤医院肿瘤内科,北京100021 [2]山东淄博万杰肿瘤医院肿瘤科

出　　处：《中华医学杂志》2016年第24期1923-1925,共3页National Medical Journal of China

摘　　要：目的探索手术后泌尿生殖道来源的少见肿瘤脐尿管癌的临床特征、病理情况、治疗方法及预后。方法回顾性分析2003年1月至2013年12月中国医学科学院肿瘤医院和山东淄博万杰肿瘤医院收治的36例手术后脐尿管癌患者的临床资料。所有的病理组织分别由两位病理医师诊断。临床特征及病理特点、治疗情况、随访结果及生存情况都被统计分析。结果36例患者中，诊断中位年龄53岁，其中男25例。所有患者均接受膀胱部分切除术及双侧盆腔淋巴结清扫术。所有病例病理结果均为腺癌，其中黏液腺癌20例、中分化腺癌7例、低分化腺癌5例、印戒细胞癌1例、混合型腺癌3例。Sheldon分期为Ⅱ期11例，Ⅲ期16例，Ⅳa期9例。所有患者均接受过内科治疗，术后化疗方案为氟尿嘧啶＋顺铂/卡铂20例，吉西他滨＋顺铂5例，氟尿嘧啶＋顺铂＋吉西他滨5例，氟尿嘧啶＋顺铂＋阿霉素6例。其中8例存在基因突变。中位随访时间为27个月。中位生存期为36个月。1年生存率为70%，5年生存率为28%。结论脐尿管癌较少见，发现时以局部晚期为主并有远处转移的倾向。初发脐尿管癌患者推荐手术，结合内科治疗可能会降低复发风险，但仍需要前瞻性临床研究去阐明。ObjectiveUrachal carcinoma is a kind of urogenital tract malignancy with a very low incidence. The objective of this study was to observe the clinical presentation, pathological condition, treatment method and outcome of patients with urachal carcinoma.MethodsA retrospective analysis of thirty-six cases of urachal carcinoma diagnosed over a period of 10 years from 2003 to 2013 was carried out. All pathologic specimens were reviewed by two separate pathologists. Clinical and histological features, treatment condition, patient follow-up and survival outcome was reviewed and calculated.ResultsThe mean age at diagnosis was 53 years. Of the thirty-six patients, twenty-five were male. All patients underwent partial cystectomy with bilateral pelvic lymph node dissection. All cases were adenocarcinoma, including 20 mucinous adenocarcinoma, 7 moderately differentiated adenocarcinoma, 5 poorly differentiated adenocarcinoma, 1 signet ring cell carcinoma, 3 hybrid adenocarcinoma. The Sheldon pathologic stage was stage Ⅱ in 11, Ⅲ in 16 and Ⅳa in 9 cases. All patients received medical oncological therapy. The median follow-up period was 27 months. The median overall survival was 36 months. One-year survival rate was 70% and five-year survival rate was 28%.ConclusionsUrachal carcinomas are rare and usually at locally advanced stage at diagnosis with a high tendency of metastases. Surgery is a key method of primary treatment and medical oncological therapy may play a role in decreasing the chances of recurrence which still needs to be explained by prospective clinical trials.

关 键 词：手术后并发症 脐尿管癌 治疗 预后 

分 类 号：R737.1[医药卫生—肿瘤]