Johansson S, Angervall L, Bengtsson U, Wahlqvist L
Cancer. 1976 Mar;37(3):1376-83. doi: 10.1002/1097-0142(197603)37:3<1376::aid-cncr2820370318>3.0.co;2-c.
The aim of the present investigation was to assess the prognosis of epithelial pelvic tumors and evaluate from multivariate analysis the influence of different morphologic and clinical factors on the prognosis. The basic data are derived from the Swedish national series of patients with epithelial renal pelvic tumors diagnosed by histologic examination during 1962-63. Ninety-four of the 102 patients studied had a urothelial pelvic tumor and eight had an epidermoid carcinoma. The corrected 5-year survival rate was 51% in the curatively operated series, 60% among the males and 33% among the females. Infiltration depth was found to be of significant importance for the 5-year survival and thus a strong predictor for prognosis. Furthermore, each tumor grade and tumor structure exerts some influence on the prognosis independent of the infiltration depth. Nine patients had verified, and 16 patients had suspected phenacetin abuse and/or renal papillary necrosis. The survival rate was low and the relative frequency of females was high in this group of patients. These data may indicate a poorer prognosis in patients with phenacetin abuse, and may explain the sex difference in 5-year survival. Thirty-eight per cent of the patients with urothelial tumors of the renal pelvis had a synchronous or asynchronous tumor elsewhere in the urinary tract. The high frequency of local recurrence as well as the high frequency of infiltrating tumors and multiple tumors indicate the necessity for a more extensive operation such as perifascial nephrectomy with total ureterectomy including a cuff of the bladder.
本研究的目的是评估上皮性肾盂肿瘤的预后，并通过多变量分析评估不同形态学和临床因素对预后的影响。基础数据来源于瑞典全国系列经组织学检查诊断为上皮性肾盂肿瘤的患者，时间跨度为1962 - 1963年。在研究的102例患者中，94例患有尿路上皮肾盂肿瘤，8例患有表皮样癌。根治性手术系列的校正5年生存率为51%，男性为60%，女性为33%。发现浸润深度对5年生存率具有重要意义，因此是预后的一个强有力预测指标。此外，每个肿瘤分级和肿瘤结构在独立于浸润深度的情况下对预后也有一定影响。9例患者经证实，16例患者疑似有非那西丁滥用和/或肾乳头坏死。该组患者生存率低且女性相对频率高。这些数据可能表明非那西丁滥用患者预后较差，并可解释5年生存率的性别差异。38%的肾盂尿路上皮肿瘤患者在尿路其他部位有同步或异时肿瘤。局部复发的高频率以及浸润性肿瘤和多发肿瘤的高频率表明有必要进行更广泛的手术，如筋膜外肾切除术加全输尿管切除术，包括膀胱袖口。
