Takahashi S, Sugimoto M, Shinohara M, Kinoshita K
Department of Urology, Tokyo Metropolitan Komagome Hospital.
Nihon Hinyokika Gakkai Zasshi. 1992 Jul;83(7):1118-23. doi: 10.5980/jpnjurol1989.83.1118.
Among 321 bladder cancer cases from 1975 to 1989, 43 cases (13.4%) were found to have multiple primary cancers (MPC) and 278 cases without MPC (86.6%). These two groups were compared with regard to their clinical and pathological features. Mean age of patients when the bladder cancer was diagnosed was 68.9 +/- 8.9 in MPC cases and 65.7 +/- 12.3 (mean +/- S.D.) in cases without MPC. The male to female ratio was 3.8 to 1 and 2.6 to 1, respectively. The common sites of MPC were the lung, stomach and rectum, all of them being the organs often involved with cancer. Prostatic cancers in eight of 12 MPC cases were incidentally found in total cystectomy specimens. The sites of the synchronous and metachronous MPC involving lung, stomach and rectum cancers showed relatively even distribution. In males, the most common synchronous MPC included prostatic cancer, but in females, the diagnosis of uterine cancer tended to be made prior to the diagnosis of bladder cancer. In two cases, there was a strong suspicion that the therapy for the first cancer contributed to the occurrence of the second cancer. In the present study, no significant differences were noted with regard to clinicopathological characteristics of bladder cancer between the group with MPC and that without MPC. The five years survival rates from the beginning of bladder cancer treatment were 48.8% and 64.9%, respectively, indicating that the prognosis of the MPC cases was significantly worse (p less than 0.05) than that of cases without MPC. The most common cause of death in MPC cases was due to cancers other than bladder (36%).(ABSTRACT TRUNCATED AT 250 WORDS)
在1975年至1989年的321例膀胱癌病例中,43例(13.4%)被发现患有多原发性癌(MPC),278例无MPC(86.6%)。对这两组病例的临床和病理特征进行了比较。MPC病例中膀胱癌确诊时患者的平均年龄为68.9±8.9岁,无MPC病例为65.7±12.3岁(平均值±标准差)。男女比例分别为3.8比1和2.6比1。MPC的常见部位是肺、胃和直肠,这些都是常发生癌症的器官。12例MPC病例中有8例的前列腺癌是在全膀胱切除标本中偶然发现的。涉及肺癌、胃癌和直肠癌的同时性和异时性MPC的部位分布相对均匀。在男性中,最常见的同时性MPC包括前列腺癌,但在女性中,子宫癌的诊断往往先于膀胱癌。有两例强烈怀疑首例癌症的治疗促成了第二例癌症的发生。在本研究中,MPC组和无MPC组之间膀胱癌的临床病理特征无显著差异。从膀胱癌治疗开始的五年生存率分别为48.8%和64.9%,表明MPC病例的预后明显比无MPC病例差(p<0.05)。MPC病例最常见的死亡原因是膀胱癌以外的癌症(36%)。(摘要截短至250字)