Sato K, Hatano T, Miyazato T, Saito S, Kashiwabara N, Igarashi M, Koyama Y, Hayakawa M, Osawa A
Department of Urology, School of Medicine, University of the Ryukyus.
Hinyokika Kiyo. 1988 Sep;34(9):1589-92.
Prognosis on evaluable 86 patients with primary bladder tumor seen during the 10 years up to 1985 was evaluated in relation to treatment mode and tumor stage. The majority of patients underwent multimodal therapies including surgery, chemotherapy and immunotherapy with picibanil (OK432). Transurethral resection of the tumor was performed as an initial surgical treatment in 49 patients, 9 of whom ultimately underwent total cystectomy. After leaving hospital, these patients were kept on immunotherapy with OK432 and topical chemotherapy with bladder instillation of mitomycin C or adriamycin (ADM) with or without systemic administration of Tegefur as long as possible. The overall actual 5-year survival rate for the patients treated by initial transurethral resection was 80%. Recurrence rate for these 49 patients was 35%. Total cystectomy with urinary diversion was performed in 37 patients who had been placed postoperatively on systemic administration of Tegafur and immunotherapy with OK 432 as long as possible. The overall actual 5-year survival rate for the patients treated with total cystectomy was 54%. The patients with pT2 and lower stage tumor had an actual 5 year survival rate of 72%, while the patients with pT3 and higher stage tumors had a survival of 10%. The high recurrence rate in the patients with superficial tumor and the low actual survival rate of the patients with pT3 and higher stage remain a problem in the treatment of bladder tumor. In recent trials, bacillus Calmette-Gúerin instillation therapy has been initiated to lower the recurrence rate in superficial tumor and we have had a satisfactory 4-year result.(ABSTRACT TRUNCATED AT 250 WORDS)
对截至1985年的10年间所见的86例可评估的原发性膀胱肿瘤患者的预后，根据治疗方式和肿瘤分期进行了评估。大多数患者接受了包括手术、化疗和匹多莫德（OK432）免疫治疗在内的多模式治疗。49例患者最初接受经尿道肿瘤切除术作为手术治疗，其中9例最终接受了全膀胱切除术。出院后，这些患者尽可能长时间接受OK432免疫治疗以及丝裂霉素C或阿霉素（ADM）膀胱灌注局部化疗，同时或不联合替加氟全身给药。最初接受经尿道切除术治疗的患者总体实际5年生存率为80%。这49例患者的复发率为35%。37例患者接受了膀胱全切术及尿流改道术，术后尽可能长时间接受替加氟全身给药和OK432免疫治疗。接受膀胱全切术治疗的患者总体实际5年生存率为54%。pT2及以下分期肿瘤患者的实际5年生存率为72%，而pT3及以上分期肿瘤患者的生存率为10%。浅表肿瘤患者的高复发率以及pT3及以上分期患者的低实际生存率仍是膀胱肿瘤治疗中的问题。在最近的试验中，已开始采用卡介苗膀胱灌注治疗以降低浅表肿瘤的复发率，我们已取得了令人满意的4年结果。（摘要截取自250字）
