Yokoyama M, Kawai K, Shoji F, Yanagisawa R, Kanemura M, Kitahara K, Fujito S
Department of Urology, Toranomon Hospital.
Nihon Hinyokika Gakkai Zasshi. 1990 Jul;81(7):1031-8. doi: 10.5980/jpnjurol1989.81.1031.
A total of 50 cases of primary tumors in the renal pelvis and ureter were treated in Tokyo University Branch Hospital (20 cases in 1966-1982) and in Tranomon Hospital (30 cases in 1977-1987). They were composed of 42 men and 8 women (5.3:1) with a mean age of 61 years. 31 patients suffered from renal pelvic tumors, 15 ureteral tumors and 4 tumors in both sites. The tumors were located in the left side in 33 cases, right in 16, and both sides in 1.86% of patients showed gross hematuria. The findings on IVP were filling defect (42%) and nonvisualization (33%). Positive urine cytology was obtained in 12 of 25 cases (48%). Surgery was performed in 47 cases. The remaining 3 cases were with advanced diseases. The surgeries were total nephroureterectomy plus ipsilateral retroperitoneal lymph node dissection in 26 cases, total nephroureterectomy without node dissection in 7, total nephroureterectomy and total cystectomy in 3, nephrectomy in 9, partial nephrectomy in 1 and segmental excision of ureter with ureteroureterostomy in one. Histologically, all tumors were transitional cell carcinoma. Over-all survival rates (Kaplan-Meier's method) of the operated patients at 1, 3, 5 years were 84.2%, 73.1% and 69.4%, respectively. The stage and grade of the tumors affected the prognosis. N factor at lymph node dissection was the most determining factor of prognosis. 3 advanced cases who did not receive surgery for primary site were treated with 5FU in 2, and with CAP in 1.2 of them died of the disease within 1 year after diagnosis, one patient was lost in follow up.(ABSTRACT TRUNCATED AT 250 WORDS)
东京大学分院（1966年至1982年的20例）和骏河台医院（1977年至1987年的30例）共收治了50例肾盂和输尿管原发性肿瘤患者。其中男性42例，女性8例（比例为5.3:1），平均年龄61岁。31例患者患有肾盂肿瘤，15例为输尿管肿瘤，4例为双侧肿瘤。肿瘤位于左侧33例，右侧16例，1.86%的患者双侧均有肿瘤。86%的患者出现肉眼血尿。静脉肾盂造影（IVP）检查结果显示充盈缺损（42%）和不显影（33%）。25例患者中有12例尿细胞学检查呈阳性（48%）。47例患者接受了手术治疗。其余3例为晚期疾病。手术方式包括26例行全肾输尿管切除术加同侧腹膜后淋巴结清扫术，7例行全肾输尿管切除术但未清扫淋巴结，3例行全肾输尿管切除术加全膀胱切除术，9例行肾切除术，1例行部分肾切除术，1例行输尿管节段性切除术加输尿管输尿管吻合术。组织学检查显示，所有肿瘤均为移行细胞癌。手术患者1年、3年、5年的总体生存率（Kaplan-Meier法）分别为84.2%、73.1%和69.4%。肿瘤的分期和分级影响预后。淋巴结清扫时的N因素是预后的最主要决定因素。3例未接受原发部位手术的晚期患者，2例接受了5-氟尿嘧啶（5FU）治疗，1例接受了环磷酰胺（CAP）治疗。其中2例在诊断后1年内死于该疾病，1例患者失访。（摘要截选至250字）
