新辅助化疗对上尿路尿路上皮癌根治术患者术后病理分期及预后影响  

作　　者：邵佳[1] 蒋康 陈可安 谢玺 于志坚 邓刚[2] 

机构地区：[1]杭州市肿瘤医院,310002 [2]浙江大学附属杭州市第一人民医院,310006

出　　处：《浙江临床医学》2019年第12期1675-1676,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 探究新辅助化疗对浸润性上尿路尿路上皮癌根治术患者的病理分期及预后产生的相关影响.方法 自2011年1月至2018年12月期间至本院就诊的上尿路尿路上皮癌患者总计120例,根据入院顺序随机分为观察组与对照组,前者在根治性肾输尿管切除术前行新辅助化疗,对照组仅行手术治疗的患者,两组术后均行标准膀胱灌注化疗.比较两组观察对象术后的病理分期、淋巴结清扫数量及预后.结果 原发肿瘤(T)观察组患者的病理分期显著低于对照组(P<0.01);观察组患者术中更易进行淋巴结的分离且术中清除的淋巴结数量显著多于对照组(P<0.001);治疗1年后初步生存率间无显著性差异(79.58%vs 73.23%,P=0.422).结论 上尿路尿路上皮癌患者术前采用新辅助化疗其病理分期分布与单纯手术相比显著降低,术中清除的淋巴结数量显著增多,可能有利于患者的远期预后.Objective To investigate whether neoadjuvant chemotherapy before high-risk radical surgery of upper urinary tract urothelial carcinoma affect the pathological stage and prognosis of the patients.Methods 120 patients with urothelial carcinoma who were admitted to our hospital during the period from 2010 to 2015 were selected randomly.Patients were divided into study and control group.The former received the radical nephroureterectomy after neoadjuvant chemotherapy,the control group only surgically treated,the clinical pathological stages was compared.Results The pathological staging of the primary tumor(T)of the study group was significantly lower than that of the control group(P<0.01);patients in the neoadjuvant chemotherapy group were more likely to undergo lymph node dissection and the number of lymph nodes was significantly higher than that of the control group(P<0.001).There was no significant difference in the primary survival rate after 1 year(79.58%vs 73.23%,p=0.42).Conclusion The preoperative neoadjuvant chemotherapy in patients with upper urinary tract urothelial carcinoma has a significantly lower pathological staging compared with that of the simple operation and the better prognosis.

关 键 词：尿路上皮癌 上尿路 新辅助化疗 根治手术 病理分期 

分 类 号：R73[医药卫生—肿瘤]