Kastritis Efstathios, Dimopoulos Meletios-Athanasios, Antoniou Nikolaos, Deliveliotis Charalambos, Chrisofos Michael, Skolarikos Andreas, Gika Dimitra, Bamias Aristotle
Department of Clinical Therapeutics, Alexandra Hospital, Athens, Greece.
Anticancer Res. 2006 Sep-Oct;26(5B):3865-9.
There is limited information about the benefit from systemic chemotherapy in non-pure Transitional Cell Carcinomas (TCCs) of the urothelial tract. In this study the efficacy of platinum-based chemotherapy in patients with pure squamous or mixed carcinomas was retrospectively analysed and compared with that in pure TCCs.
Analysis included 446 consecutive patients treated with platinum-based chemotherapy for advanced or metastatic urothelial cancer. There were 389 (87%) patients with pure TCC, 15 (3.5%) with pure Squamous Cell Carcinomas (SCC) and 42 (9.5%) patients had mixed histology (TCC+SCC) tumors.
There were no statistically significant differences in baseline characteristics (gender, PS, haemoglobin, sites of metastases) although disease in the pelvis was more frequent in mixed tumors than in pure TCCs (46% vs. 30%, p = 0.034). Median survival for patients with TCC histology was 11.3 months, for SCC patients 13.6 months and 10.4 months for patients with mixed histology (p = 0.720). Response rates were 44% for patients with TCC, 27% for patients with SCC and 34% for mixed histology patients (p = 0.210). Multivariate analysis showed that presence of visceral metastases and poor performance status, were associated with worse prognosis in mixed histology tumors.
Non-transitional histology does not predict for an inferior survival after platinum-based chemotherapy for advanced urothelial carcinoma. Well-known prognostic factors in transitional cell carcinomas were also associated with prognosis in mixed carcinomas.
关于全身化疗对尿路上皮非纯移行细胞癌（TCC）的益处，目前信息有限。在本研究中，我们回顾性分析了铂类化疗对纯鳞状或混合性癌患者的疗效，并与纯TCC患者进行了比较。
分析纳入了446例接受铂类化疗的晚期或转移性尿路上皮癌患者。其中389例（87%）为纯TCC患者，15例（3.5%）为纯鳞状细胞癌（SCC）患者，42例（9.5%）为混合组织学类型（TCC+SCC）肿瘤患者。
尽管混合性肿瘤患者盆腔疾病的发生率高于纯TCC患者（46%对30%，p=0.034），但在基线特征（性别、体能状态、血红蛋白、转移部位）方面无统计学显著差异。TCC组织学类型患者的中位生存期为11.3个月，SCC患者为13.6个月，混合组织学类型患者为10.4个月（p=0.720）。TCC患者的缓解率为44%，SCC患者为27%，混合组织学类型患者为34%（p=0.210）。多因素分析显示，内脏转移的存在和较差的体能状态与混合组织学肿瘤的预后较差相关。
非移行组织学类型并不能预测晚期尿路上皮癌铂类化疗后的生存期较差。移行细胞癌中众所周知的预后因素也与混合性癌的预后相关。
