Wang T M, Chang P L, Huang S T, Hsieh M L, Tsui K H
Department of Urology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1998 Dec;21(4):415-20.
There is a limited amount of information available on treatment efficacy and optimal management of squamous cell carcinoma of bladder. The goal of this study was to assess the long-term outcome of patients with squamous cell carcinoma of the bladder treated using different modalities.
Retrospective analysis of the medical records of 22 patients with squamous cell carcinoma of the bladder treated at Chang Gung Memorial Hospital from 1986 though 1996 was performed. The follow-up period ranged from 12 months to 111 months.
The treatment modalities included transurethral resection in 7 patients, radical cystectomy with urinary diversion in 6 patients, preoperative radiation followed by total cystectomy in 8 patients, and partial cystectomy in one patient. The overall 5-year survival rate was 9%. Only 6 patients (27.3%) in this series were alive two years after diagnosis. Treatment using a combination of modalities including preoperative radiation followed by total cystectomy resulted in a 5-year survival rate of 12.5% in 8 patients. Total cystectomy alone in 6 patients resulted in a 5-year survival rate of 0%. However, the difference in survival rates between these 2 treatment groups was not statistically significant.
Our results suggest that no definite significance concerning the role of preoperative radiation followed by total cystectomy could be drawn. The results were probably because most of our patients had locally advanced bladder cancer. Another consideration is the small sample size, which may have affected the significance. Although, cystectomy did not improve the 5-year survival rate of patients in this series, it improved the 2-year survival rate.
关于膀胱鳞状细胞癌的治疗效果和最佳管理的可用信息有限。本研究的目的是评估采用不同治疗方式的膀胱鳞状细胞癌患者的长期预后。
对1986年至1996年在长庚纪念医院接受治疗的22例膀胱鳞状细胞癌患者的病历进行回顾性分析。随访期为12个月至111个月。
治疗方式包括7例经尿道切除术、6例行根治性膀胱切除术加尿流改道术、8例术前放疗后行全膀胱切除术、1例行部分膀胱切除术。总体5年生存率为9%。本系列中只有6例患者(27.3%)在诊断后两年仍存活。采用术前放疗后行全膀胱切除术等多种治疗方式,8例患者的5年生存率为12.5%。6例单纯行全膀胱切除术患者的5年生存率为0%。然而,这两个治疗组的生存率差异无统计学意义。
我们的结果表明,术前放疗后行全膀胱切除术的作用尚无明确意义。结果可能是因为我们的大多数患者患有局部晚期膀胱癌。另一个考虑因素是样本量小,这可能影响了统计学意义。虽然,膀胱切除术并未提高本系列患者的5年生存率,但提高了2年生存率。