Shinohara M, Okazawa A, Suzuki M, Itakura H, Munakata A, Kinoshita K
Department of Urology, Tokyo Metropolitane Komagome General Hospital.
Nihon Hinyokika Gakkai Zasshi. 1995 Aug;86(8):1375-82. doi: 10.5980/jpnjurol1989.86.1375.
Clinical investigation of 93 patients with histologically confirmed renal pelvic and ureteral cancer were performed. These patients consisted of 55 males and 38 females with a mean age of 64.8 years. There were 61 cases of renal pelvic cancer, 55 cases of ureteral cancer and 23 with cancers of both sites. Thirty-four cases were associated with bladder cancer and 41 of 82 patients had multiple tumors. The overall 5-year survival rate was 46.0%. 5-year survival of stages pTa, pT1, pT2, pT3, and pT4, was 93.3%, 71.8%, 37.5%, 30.4% and 10.5%, respectively. In this report, we evaluated various prognostic factors according to the survival rate. Sex, age, tumor localization, multiplicity, associated bladder cancer and concomitance of CIS had no influence on survival. In the ABC analysis, the B group showed a tendency for a poor prognosis. However it may be explained from the fact that the B group contained more patients at advanced stages than the other groups. Tumor grade, tumor stage, pV factor and pL factor had a significant effect on survivals. But tumor grade, pV and pL factors were closely related to the tumor stage. Thus the stage was thought to be the most important factor in the prognosis of upper urinary tract cancer. Different surgical procedures and irradiation also did not affect the prognosis of the patients with the same degree of invasion. Chemotherapy for all stages had no effect on survivals compared with non-chemotherapeutic group. However only for pT3 and higher stage cases, cisplatin-based chemotherapy improved the prognosis compared with patients not given chemotherapy. In conclusion, chemotherapy containing cisplatin should be considered for treatment of high stage upper urinary tract cancer.
对93例经组织学确诊的肾盂及输尿管癌患者进行了临床研究。这些患者包括55名男性和38名女性，平均年龄为64.8岁。其中肾盂癌61例，输尿管癌55例，双侧癌23例。34例合并膀胱癌，82例患者中有41例有多发肿瘤。总体5年生存率为46.0%。pTa、pT1、pT2、pT3和pT4期的5年生存率分别为93.3%、71.8%、37.5%、30.4%和10.5%。在本报告中，我们根据生存率评估了各种预后因素。性别、年龄、肿瘤部位、多发性、合并膀胱癌及伴发原位癌对生存率均无影响。在ABC分析中，B组显示出预后较差的趋势。然而，这可能是因为B组中晚期患者比其他组更多。肿瘤分级、肿瘤分期、pV因子和pL因子对生存率有显著影响。但肿瘤分级、pV和pL因子与肿瘤分期密切相关。因此，分期被认为是上尿路癌预后的最重要因素。不同的手术方式和放疗对相同浸润程度的患者预后也无影响。与未化疗组相比，各期化疗对生存率均无影响。然而，仅对于pT3及更高分期的病例，与未接受化疗的患者相比，以顺铂为基础的化疗改善了预后。总之，对于晚期上尿路癌的治疗应考虑含顺铂的化疗。
