Pang Cheng, Guan Youyan, Li Hongbo, Chen Wanqing, Zhu Gang
Graduate School of Peking Union Medical College, Beijing Department of Urology, Beijing Hospital of the Ministry of Health, Beijing.
Department of Urology, Cancer Hospital of Chinese Academy of Medical Science and Peking Union Medical College, National Cancer Center, Beijing.
Jpn J Clin Oncol. 2016 Jun;46(6):497-501. doi: 10.1093/jjco/hyw034. Epub 2016 Apr 4.
Cancer remains to be the second most common cause of death, and its incidence and mortality rates are increasing in China. According to the 2015 National Central Cancer Registry (NCCR) of China, the incidence of bladder cancer and prostate cancer ranked sixth and seventh, respectively, in male cancers. The majority of prostate cancer patients were diagnosed at an advanced stage. Early diagnosis of prostate cancer is the key to improve prostate cancer survival in China. Radical prostatectomy or radical radiotherapy is the main treatment for localized prostate cancer, and a comprehensive therapy based on androgen deprivation therapy is the treatment for advanced disease. The most common histologic types of bladder cancer in China were urothelial carcinoma, followed by adenocarcinoma and squamous carcinoma. The majority of patients were diagnosed using white-light cystoscopy with biopsy. Fluorescence and narrow-band imaging cystoscopy had additional detection rates and are becoming more popular. Following Chinese guidelines, most non-muscle invasive bladder cancer patients were treated with diagnostic transurethral resection and more than half of the muscle invasive bladder cancer patients were treated with radical cystectomy. Due to the increased detection rate of kidney tumors by ultrasound in physical examination, the number of incidentally diagnosed renal cell carcinoma has increased. Localized kidney cancers are more and more often treated by nephron-sparing surgery. Radical nephrectomy is still the main treatment option for patients with locally advanced renal cell carcinoma. Both laparoscopic and robotic-assisted laparoscopic surgeries have been used in big medical centers. Both testicular cancer and penile cancer have lower incidence levels than that in Europe. As we have an enormous population base, the absolute patient number is big. The diagnosis and treatment follows the Chinese guidelines. In China, both medical professionals and public should concern more on the early diagnosis, as there is not enough cancer prevention information available. Urologists should also take a more active role in educating the population.
癌症仍是第二大常见死因，在中国其发病率和死亡率呈上升趋势。根据2015年中国国家癌症中心登记处（NCCR）的数据，膀胱癌和前列腺癌的发病率在男性癌症中分别位列第六和第七。大多数前列腺癌患者在晚期才被诊断出来。早期诊断前列腺癌是提高中国前列腺癌患者生存率的关键。根治性前列腺切除术或根治性放疗是局限性前列腺癌的主要治疗方法，而基于雄激素剥夺疗法的综合治疗则用于晚期疾病。中国膀胱癌最常见的组织学类型是尿路上皮癌，其次是腺癌和鳞状细胞癌。大多数患者通过白光膀胱镜检查并活检来诊断。荧光和窄带成像膀胱镜检查有更高的检出率，且越来越受欢迎。按照中国的指南，大多数非肌层浸润性膀胱癌患者接受诊断性经尿道切除术治疗，超过一半的肌层浸润性膀胱癌患者接受根治性膀胱切除术治疗。由于体检中超声对肾肿瘤的检出率增加，偶然诊断出的肾细胞癌数量有所上升。局限性肾癌越来越多地采用保留肾单位手术治疗。根治性肾切除术仍是局部晚期肾细胞癌患者的主要治疗选择。大型医疗中心已采用腹腔镜和机器人辅助腹腔镜手术。睾丸癌和阴茎癌的发病率均低于欧洲。由于我们有庞大的人口基数，患者绝对数量很大。诊断和治疗遵循中国的指南。在中国，由于缺乏足够的癌症预防信息，医疗专业人员和公众都应更加关注早期诊断。泌尿外科医生也应在对公众进行教育方面发挥更积极的作用。
