Malmström P U, Busch C, Norlén B J
Department of Urology, Uppsala University, Akademiska sjukhuset, Sweden.
Scand J Urol Nephrol. 1987;21(3):185-95. doi: 10.3109/00365598709180320.
A retrospective study of 232 bladder tumours with minimum follow-up 5 years is presented. The carcinoma was superficial in 66%, muscle-invasive in 31% and could not be staged in 3%. Primary treatment was mainly transurethral resection for superficial tumour, but was cystectomy or radiotherapy in 22 of 29 T1 G3. Of the superficial tumours, 71% recurred. Progression to higher T stage occurred in 15% of Ta and 29% of T1 tumours, and half of these patients died of bladder cancer. The corrected 5-year survival rates in grades 1, 2A, 2B and 3-4 were 96, 84, 64 and 43%, and in stages Ta, T1, T2 and T3 they were 94, 69, 40 and 31%. All patients with T4 tumour died within 4 years. Among the 45 patients with 40 Gy irradiation + cystectomy, the corrected 5-year survival rate was 83% in superficial and 64% in muscle-invasive tumours, and among the 38 with radical radiotherapy the rates in T1-3 were 46, 36 and 13%. Transurethral resection was successful in most Ta cases. Most T1 tumours were, like T2-4, of higher grade than Ta. Prognosis was worse in T1 than in Ta. After progression to muscle-invasive disease, even during close follow-up the outlook was poor, as poor as for patients with primary muscle-invasive disease.
本文呈现了一项对232例膀胱肿瘤的回顾性研究，这些患者的最短随访时间为5年。66%的癌为浅表性，31%为肌层浸润性，3%无法分期。浅表肿瘤的主要初始治疗为经尿道切除术，但在29例T1 G3肿瘤中有22例接受了膀胱切除术或放疗。在浅表肿瘤中，71%出现复发。Ta肿瘤中有15%、T1肿瘤中有29%进展至更高T分期，其中一半患者死于膀胱癌。1级、2A、2B和3 - 4级的校正5年生存率分别为96%、84%、64%和43%，Ta、T1、T2和T3期的校正5年生存率分别为94%、69%、40%和31%。所有T4期肿瘤患者均在4年内死亡。在45例接受40 Gy放疗 + 膀胱切除术的患者中，浅表肿瘤的校正5年生存率为83%，肌层浸润性肿瘤为64%；在38例接受根治性放疗的患者中，T1 - 3期的生存率分别为46%、36%和13%。经尿道切除术在大多数Ta病例中取得成功。大多数T1肿瘤与T2 - 4肿瘤一样，分级高于Ta。T1的预后比Ta差。进展为肌层浸润性疾病后，即使在密切随访期间，预后也很差，与原发性肌层浸润性疾病患者的预后一样差。
