Sengeløv L, Kamby C, von der Maase H
Department of Oncology, Herlev University Hospital, Copenhagen.
J Urol. 1996 Jan;155(1):111-4.
The anatomical pattern of recurrence and metastases in patients with urothelial cancer are described, and the relationship between treatment and features of the primary invasive tumor and the subsequent pattern of metastases is analyzed.
Between 1976 and 1991, 240 patients with recurrent or metastatic urothelial cancer were admitted to our department.
The majority of the patients had recurrence within 2 years after initial diagnosis. Local recurrences and lung metastases were diagnosed significantly earlier than other metastases. Multiple sites were involved in more than half of the patients. The most common sites of recurrence were local in the bladder in 65% of the cases and bone in 35%, followed by lymph nodes in 26% and lung in 20%. The pattern of metastases was similar in patients with different histological findings, grade and location of the primary tumor. Patients younger than 60 years and those with cancer of the renal pelvis more often had distant metastases compared to older patients with bladder cancer. Local recurrences were less frequent in patients who had undergone cystectomy compared to those treated with radiotherapy only. Moreover, patients with local recurrences were likely to have metastases elsewhere.
Bone was the most frequent site of metastases outside the pelvis and all patients suspected to have recurrence should be examined for bone metastases. The results indicate that the pattern of recurrence and metastases are not dependent on the features of the primary tumor.
描述尿路上皮癌患者复发和转移的解剖学模式，并分析治疗与原发性浸润性肿瘤特征及后续转移模式之间的关系。
1976年至1991年间，240例复发或转移性尿路上皮癌患者入住我科。
大多数患者在初次诊断后2年内复发。局部复发和肺转移的诊断明显早于其他转移。超过半数患者出现多个部位受累。最常见的复发部位是膀胱局部，占65%，其次是骨转移，占35%，然后是淋巴结转移，占26%，肺转移占20%。不同组织学表现、原发肿瘤分级和部位的患者转移模式相似。与老年膀胱癌患者相比，60岁以下患者和肾盂癌患者更常发生远处转移。与仅接受放疗的患者相比，接受膀胱切除术的患者局部复发较少。此外，发生局部复发的患者可能在其他部位发生转移。
骨是盆腔外最常见的转移部位，所有疑似复发的患者均应检查是否有骨转移。结果表明，复发和转移模式不依赖于原发性肿瘤的特征。
