Konnak J W, Grossman H B
Urology. 1985 Dec;26(6):550-3. doi: 10.1016/0090-4295(85)90358-9.
Between 1971 and 1983 we performed 18 salvage cystectomies on patients with recurrent transitional cell bladder cancer initially treated with definitive radiation therapy (5,500-6,820 R). The interval between tumor diagnosis and radiation ranged from zero to twenty-one years (mean 3.5 years), and the interval between radiation therapy and cystectomy ranged between six months and twelve years (mean 2.5 years). Early major complications occurred in 5 patients, and there was one early and one late postoperative death. The overall patient survival from the time of diagnosis to death or the present (1985) ranged from two to thirty-one years (mean 9.8 years), and from the time of radiation to the present or death ranged from one to nineteen years (mean 6.2 years). The overall crude five-year survival from the time of cystectomy excluding 2 patients operated on in 1982 and 1983 was 50 per cent, however 3 of these patients died of cancer after five years. Breakdown of survival of these patients by stage demonstrated the best survival in patients with carcinoma in situ and Stage A or no neoplasm at the time of cystectomy. This report confirms the value of salvage cystectomy after radiation failure in invasive transitional cell bladder cancer.
1971年至1983年间，我们对18例复发性移行细胞膀胱癌患者实施了挽救性膀胱切除术，这些患者最初接受了根治性放射治疗（5500 - 6820拉德）。肿瘤诊断与放疗之间的间隔时间为0至21年（平均3.5年），放疗与膀胱切除术之间的间隔时间为6个月至12年（平均2.5年）。5例患者出现早期严重并发症，术后有1例早期死亡和1例晚期死亡。从诊断到死亡或至1985年的总体患者生存期为2至31年（平均9.8年），从放疗到现在或死亡的生存期为1至19年（平均6.2年）。排除1982年和1983年接受手术的2例患者后，膀胱切除术后总体粗略五年生存率为50%，然而这些患者中有3例在五年后死于癌症。根据分期对这些患者的生存情况进行分析，结果显示膀胱切除时处于原位癌和A期或无肿瘤的患者生存率最佳。本报告证实了侵袭性移行细胞膀胱癌放疗失败后挽救性膀胱切除术的价值。
