Pagano F, Guazzieri S, Artibani W, Prayer-Galetti T, Milani C, Bassi P, Garbeglio A
Department of Urology, University of Padua, Italy.
Eur Urol. 1988;15(3-4):166-70. doi: 10.1159/000473425.
From January 1979 to June 1982, 141 consecutive patients with bladder transitional cell carcinoma were treated with a single stage lymphadenectomy plus radical cystectomy. The survival rate observed in our patients, based on the TNM classification, was comparable with that reported for other groups employing contemporary surgery. Survivorship for patients with deep invasive tumors was also estimated by breaking down the pT3 stage, and patients with tumor confined to the bladder wall (pT3a) were separately evaluated from those with tumor extended outside (pT3b). The results obtained with this subdivision showed that pT3a patients have almost the same survival rate as pT2 patients. From these results it is concluded that radical cystectomy is a satisfactory curative treatment of bladder cancer confined to the bladder wall, whatever the extension of the muscular involvement. Such considerations suggest that, in order to achieve a more objective analysis of the results after radical cystectomy for invasive bladder cancer, a modification of clinical staging is necessary. Moreover, a simplification of the classification methods should provide a better identification of the elements required to assess the prognosis and to improve treatment planning.
1979年1月至1982年6月，141例连续性膀胱移行细胞癌患者接受了一期淋巴结清扫术加根治性膀胱切除术。根据TNM分类法，我们患者的生存率与采用当代手术的其他组报告的生存率相当。对于浸润性较深的肿瘤患者，还通过细分pT3期来评估其生存率，肿瘤局限于膀胱壁的患者（pT3a）与肿瘤扩展至膀胱壁外的患者（pT3b）分开评估。这种细分得到的结果表明，pT3a患者的生存率与pT2患者几乎相同。从这些结果可以得出结论，无论肌肉受累程度如何，根治性膀胱切除术对于局限于膀胱壁的膀胱癌都是一种令人满意的治愈性治疗方法。这些考虑表明，为了对浸润性膀胱癌根治性膀胱切除术后的结果进行更客观的分析，有必要对临床分期进行修改。此外，简化分类方法应能更好地识别评估预后和改进治疗计划所需的因素。
