Murphy D M, Zincke H, Furlow W L
J Urol. 1980 May;123(5):629-31. doi: 10.1016/s0022-5347(17)56069-3.
During a 22-year period 224 patients were seen for treatment of transitional cell carcinoma of the renal pelvis or ureter. Of these patients 49 (22 per cent) had grade 1 lesions. Followup ranged from 5 to 25 years. The most common symptom was hematuria. In only 54 per cent of the 49 patients was a filling defect noted on excretory urography. Forty-seven patients (96 per cent) had stage I disease. Treatment included total nephroureterectomy, nephrectomy or segmental resection. In 11 patients (23 per cent) evidence of bladder tumor developed 8 months to 12 years (average 4 years) after the diagnosis of tumor of the upper urinary tract and 73 per cent of these recurrences were noted within the first 3 years. In 1 patient a tumor developed in the opposite upper urinary tract. In only 1 of 15 patients who had had partial ureterectomy or local excision tumor developed in the ipsilateral ureter. Patient survival time was identical to that in an age-matched control group. We conclude that the most significant findings are the subsequent high incidence (23 per cent) of bladder tumor and the comparable survival in these pateints and in an age-matched control group. Furthermore, these results suggest that operations preserving the renal parenchyma, that is segmental resection, should be used more frequently.
在22年期间，有224例患者因肾盂或输尿管移行细胞癌前来接受治疗。其中49例（22%）为1级病变。随访时间为5至25年。最常见的症状是血尿。在这49例患者中，只有54%在排泄性尿路造影中发现充盈缺损。47例患者（96%）处于I期疾病。治疗方法包括全肾输尿管切除术、肾切除术或节段性切除术。11例患者（23%）在诊断上尿路肿瘤后8个月至12年（平均4年）出现膀胱肿瘤证据，其中73%的复发在头3年内被发现。1例患者在对侧上尿路出现肿瘤。在15例接受部分输尿管切除术或局部切除术的患者中，只有1例在同侧输尿管出现肿瘤。患者的生存时间与年龄匹配的对照组相同。我们得出的结论是，最显著的发现是随后膀胱肿瘤的高发病率（23%）以及这些患者与年龄匹配的对照组相当的生存率。此外，这些结果表明，应更频繁地使用保留肾实质的手术，即节段性切除术。
