Das A K, Carson C C, Bolick D, Paulson D F
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
Cancer. 1990 Nov 1;66(9):1919-23. doi: 10.1002/1097-0142(19901101)66:9<1919::aid-cncr2820660911>3.0.co;2-z.
The pathologic material and medical records of 76 patients with primary upper urinary tract carcinomas were reviewed to identify the role of grade and stage in predicting survival; to determine any differences in survival between ureteral and renal pelvic carcinoma; to understand the role of local therapy in low grade, low stage tumors; and to establish the usefulness of adjuvant therapies in metastatic disease. Kaplan-Meier survival curves with Cox-Mantel analysis for statistical significance revealed both grade and stage to be excellent predictors of survival. No differences in survival were noted between renal pelvic and ureteral carcinomas for equivalent stage tumors. For low grade, low stage tumors, although there was an increased risk of local recurrence with local therapy, there were no differences in survival between patients treated with local therapy or radical surgery. Finally, cisplatin-based chemotherapy seemed to improve survival in patients with metastatic disease.
回顾了76例原发性上尿路癌患者的病理资料和医疗记录，以确定分级和分期在预测生存率方面的作用；确定输尿管癌和肾盂癌在生存率上的差异；了解局部治疗在低分级、低分期肿瘤中的作用；以及确定辅助治疗在转移性疾病中的有效性。采用Kaplan-Meier生存曲线和Cox-Mantel分析以确定统计学意义，结果显示分级和分期均是生存率的良好预测指标。对于相同分期的肿瘤，肾盂癌和输尿管癌在生存率上无差异。对于低分级、低分期肿瘤，尽管局部治疗会增加局部复发风险，但接受局部治疗或根治性手术的患者在生存率上并无差异。最后，以顺铂为基础的化疗似乎可提高转移性疾病患者的生存率。
