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[膀胱切除术或经尿道切除术治疗膀胱癌]

[Cystectomy or transurethral resection in the treatment of bladder carcinoma].

作者信息

Flamm J, Kiesswetter H, Burkert S

出版信息

Z Urol Nephrol. 1982 Oct;75(10):729-37.

PMID:7158092
Abstract

136 patients with carcinoma of the bladder were followed up after cystectomy and ileal conduit (n = 50), and TUR with post-operative irradiation (n = 86) with betatron (n = 35) or telecobalt (n = 51). The 3-year survival rate after cystectomy was 40% for all stages, the early mortality rate was around 14%. The complication rate was 16%. In the second half the survival rate was improved to 69.2% and the early mortality rate was lowered to 7.9%. After TUR and irradiation the 3-year survival rate was 48% for all stages, whereby 41% of the survivors or 20% of all patients had no further recurrence of tumours. Understaging with questionable removal in the healthy person and high persistence and recurrence are the methodic limits to TUR; a high early mortality rate and secondary late complications are the burden of cystectomy, besides psychological factors. Indications and results are discussed on the basis of the literature and an individual approach is recommended.

摘要

对136例膀胱癌患者进行了随访,其中50例行膀胱切除术及回肠代膀胱术,86例行经尿道膀胱肿瘤切除术(TUR)并术后放疗,放疗采用电子感应加速器(35例)或远距离钴治疗(51例)。膀胱切除术后所有分期的3年生存率为40%,早期死亡率约为14%。并发症发生率为16%。在后半段时间,生存率提高到69.2%,早期死亡率降至7.9%。TUR及放疗后所有分期的3年生存率为48%,其中41%的幸存者或20%的所有患者肿瘤无进一步复发。TUR的方法学局限性在于对健康人分期不足、切除可疑、高持续性和高复发率;除心理因素外,膀胱切除术的负担在于高早期死亡率和继发性晚期并发症。基于文献讨论了适应证和结果,并推荐个体化治疗方法。

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