Yu Shao-Long, Hou Guo-Liang, Zhou Fang-Jian, Liu Zhuo-Wei, Han Hui, Qin Zi-Ke, Li Yong-Hong, Zhang Zhi-Ling, Yao Kai
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China.
Ai Zheng. 2009 May;28(5):500-5.
Radical cystectomy and urinary diversion is universally accepted as the most effective treatment for muscle invasive bladder cancer, but the operation is complicated, time-consuming and causes many complications. This study was to summarize our experience and clinical outcomes of modified radical cystectomy in the treatment of patients with muscle invasive bladder cancer.
In total 188 patients with invasive bladder cancer treated in the Department of Urology, Sun Yat-sen University Cancer Center from January 2000 to December 2007 with modified radical cystectomy and urinary diversion were analyzed retrospectively. Patients were followed up for 2 to 97 months, with a median of 31 months.
The operative time was 120-525 min, with a median of 300 min. Blood transfusion was required in 39.9% of the patients. There was no operation-related death. The 5-year recurrence free and 5-year overall survival rates were 74.9% and 71.5%, respectively. The 5-year and overall survival were 82.5% and 82.8% for patients with organ-confined bladder cancer, 19.0% and 34.3% for patients with extravesical extension of bladder cancer, 82.2% and 79.1% for lymph node-negative patients, and 25.2% and 11.4% for lymph node positive patients.
Modified radical cystectomy and urinary diversion is an effective and safe approach in treating muscle invasive bladder cancer. The efficacy of radical cystectomy is limited for the treatment of patients with extravesical extension of bladder cancer and lymph node positive patients.
根治性膀胱切除术及尿流改道术是公认的治疗肌层浸润性膀胱癌最有效的方法，但该手术复杂、耗时且会引发多种并发症。本研究旨在总结我们采用改良根治性膀胱切除术治疗肌层浸润性膀胱癌患者的经验及临床疗效。
回顾性分析2000年1月至2007年12月在中山大学肿瘤防治中心泌尿外科接受改良根治性膀胱切除术及尿流改道术的188例浸润性膀胱癌患者。患者随访2至97个月，中位随访时间为31个月。
手术时间为120 - 525分钟，中位时间为300分钟。39.9%的患者需要输血。无手术相关死亡病例。5年无复发生存率和5年总生存率分别为74.9%和71.5%。局限于器官内的膀胱癌患者5年和总生存率分别为82.5%和82.8%，膀胱外浸润的膀胱癌患者分别为19.0%和34.3%，淋巴结阴性患者分别为82.2%和79.1%，淋巴结阳性患者分别为25.2%和11.4%。
改良根治性膀胱切除术及尿流改道术是治疗肌层浸润性膀胱癌的一种有效且安全的方法。根治性膀胱切除术对膀胱外浸润及淋巴结阳性患者的治疗效果有限。
