Miyakawa M, Oishi K, Okada Y, Takeuchi H, Okada K, Yoshida O
Hinyokika Kiyo. 1986 Dec;32(12):1931-9.
Of the 843 patients with bladder cancer treated at Kyoto University between 1965 and 1984, 156 patients (18.6%) received total cystectomy. Between 1980 and 1984, 60 patients underwent multidisciplinary treatment with 4,000 or 2,400 rad adjuvant preoperative radiation therapy to the whole pelvis followed by radical cystectomy with or without postoperative adjuvant chemotherapy. The 5-year survival rate for the 65 patients with pelvic lymphadenectomy was 66% and that for the 40 patients without lymphadenectomy or only biopsy was 35%. The 5-year survival rate after radical cystectomy for 20 bladder cancer patients with regional lymph node metastasis was 11% and 73% for 59 patients without lymph node metastasis (p less than 0.001). The survival rate of multidisciplinary treatment protocol for muscle invasive bladder cancer was 55% a significantly (p less than 0.05) improved survival compared to the historical control. For analysis, the patients were divided into 2 categories according to histological criteria for evaluation of therapeutic effects for preoperative radiation by Ohoshi and Shimosato. The two groups were non-responder: grade I and IIa changes and responder: grade IIb, III and IV. Survival for responders and non-responders revealed significant differences (p less than 0.05), 87% for 28 responders and 48% for 24 non-responders.
1965年至1984年间，在京都大学接受治疗的843例膀胱癌患者中，156例（18.6%）接受了全膀胱切除术。1980年至1984年间，60例患者接受了多学科治疗，术前对全盆腔进行4000或2400拉德的辅助放疗，然后进行根治性膀胱切除术，术后可进行或不进行辅助化疗。65例行盆腔淋巴结清扫术患者的5年生存率为66%，40例未行淋巴结清扫术或仅行活检患者的5年生存率为35%。20例有区域淋巴结转移的膀胱癌患者根治性膀胱切除术后的5年生存率为11%，59例无淋巴结转移患者的5年生存率为73%（p<0.001）。肌肉浸润性膀胱癌多学科治疗方案的生存率为55%，与历史对照相比，生存率有显著提高（p<0.05）。为了进行分析，根据Ohoshi和Shimosato对术前放疗治疗效果的组织学标准，将患者分为两类。两组分别为无反应者：I级和IIa级改变，以及有反应者：IIb级、III级和IV级。有反应者和无反应者的生存率有显著差异（p<0.05），28例有反应者的生存率为87%，24例无反应者的生存率为48%。
