Palou J, Fariña L A, Villavicencio H, Vicente J
Instituto de Urología, Nefrología y Andrología, Fundación Puigvert, Barcelona, Spain.
Eur Urol. 1992;21(2):110-4. doi: 10.1159/000474814.
We present a retrospective review of 30 patients who developed upper urinary tract tumors (UUTT) after having been diagnosed and treated for a bladder neoplasm. The mean patient age was 63 years (range 54-72). An average of 4.8 (range 1-10) transurethral resections (TUR) had been performed for bladder cancer prior to the appearance of UUTT. The length of time elapsed between the initial bladder TUR and the subsequent diagnosis of UUTT was variable, with increased incidence in the first 24-72 months (63.3% of the cases). In 21 cases (70%) the bladder tumor was multiple and in 28 (93.3%) the tumor was recurrent. In those patients with unilateral vesicoureteral reflux, an increased incidence of UUTT was found in the refluxing renal unit. In patients with poorly differentiated (grade 3 and grade 2-3) bladder tumors, UUTT was of the similar grade of anaplasia in 75% of cases. These observations, together with those previously published in the literature, allow us to recommend the use of excretory urography (IVP) every 2 years during the first 6 years of follow-up in patients treated for recurrent and/or multiple bladder tumor. Thereafter, follow-up would depend upon the individual clinical situation.
我们对30例在诊断和治疗膀胱肿瘤后发生上尿路肿瘤（UUTT）的患者进行了回顾性研究。患者的平均年龄为63岁（范围54 - 72岁）。在UUTT出现之前，平均已针对膀胱癌进行了4.8次（范围1 - 10次）经尿道切除术（TUR）。从最初的膀胱TUR到随后诊断出UUTT之间的时间间隔各不相同，在前24 - 72个月发病率增加（占病例的63.3%）。21例（70%）膀胱肿瘤为多发性，28例（93.3%）肿瘤复发。在那些有单侧膀胱输尿管反流的患者中，反流的肾单位中UUTT的发病率增加。在低分化（3级和2 - 3级）膀胱肿瘤患者中，75%的病例UUTT的间变程度相似。这些观察结果，连同先前文献中发表的那些结果，使我们建议在复发性和/或多发性膀胱肿瘤患者的随访的前6年中，每2年进行一次排泄性尿路造影（IVP）。此后，随访将取决于个体临床情况。
