Rausch Steffen, Hofmann Rainer, von Knobloch Rolf
Department of Urology, University Hospital Marburg, Germany.
Urol Ann. 2012 Jan;4(1):14-8. doi: 10.4103/0974-7796.91615.
Urinary tract squamous cell carcinoma and transitional cell carcinoma with squamous differentiation are rare entities. To characterize tumour biology, prognosis, and therapy, we reviewed our data with squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC/SCC).
We performed a retrospective single-center analysis of 53 patients with SCC and TCC/SCC treated at our urology department from 30.05.1989 to 30.09.2004.
SCC was found in 2% (42/1573) of bladder carcinoma and 7% (11/130) of renal pelvis specimen. Stage pT3 was present in 55% of our patients, indicating a tendency to deep muscular invasion. Nodal and distant metastases appeared in 26%. The overall 5-year survival rate was 26% (tumor specific 46%), with a median survival of 10.5 months. We found that three of four patients with pT2N0 bladder carcinoma could be cured by cystectomy. Lymphnode status was identified as a significant prognostic parameter. For renal pelvis carcinoma, median survival was 7.35 months, with an overall 5-year-survival of 30%. Adjuvant therapy modalities were only performed in a minority of cases, although a therapeutic response was often noticed.
SCC is characterized by poor prognosis and individual tumor biology. Survival is related to local tumor extension, indicating the necessity of an early radical surgery. To adequately discuss the role of adjuvant therapy on SCC and TCC/SCC further trials are needed.
尿路鳞状细胞癌以及伴有鳞状分化的移行细胞癌是罕见的实体肿瘤。为了描述肿瘤生物学、预后及治疗情况,我们回顾了鳞状细胞癌(SCC)和移行细胞癌(TCC/SCC)的相关数据。
我们对1989年5月30日至2004年9月30日在我院泌尿外科接受治疗的53例SCC和TCC/SCC患者进行了回顾性单中心分析。
在膀胱癌患者中,SCC的发生率为2%(42/1573),在肾盂标本中为7%(11/130)。55%的患者为pT3期,表明有深层肌肉浸润倾向。26%的患者出现淋巴结及远处转移。总体5年生存率为26%(肿瘤特异性生存率为46%),中位生存期为10.5个月。我们发现,4例pT2N0期膀胱癌患者中有3例可通过膀胱切除术治愈。淋巴结状态被确定为一个重要的预后参数。对于肾盂癌,中位生存期为7.35个月,总体5年生存率为30%。辅助治疗方式仅在少数病例中实施,尽管常观察到治疗反应。
SCC具有预后差和个体肿瘤生物学特性。生存率与局部肿瘤扩展有关,这表明早期根治性手术的必要性。为了充分讨论辅助治疗对SCC和TCC/SCC的作用,还需要进一步的试验。