Jarrett T W, Sweetser P M, Weiss G H, Smith A D
Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
J Urol. 1995 Nov;154(5):1629-35.
We establish the effectiveness of percutaneous resection of transitional cell carcinomas of the renal collecting system.
A retrospective analysis was done of 36 kidneys treated during a 9-year period. Adjunctive therapy with bacillus Calmette-Guerin was given in 19 cases.
Of 36 kidneys 6 were treated by immediate nephroureterectomy for aggressive disease, leaving 30 units treated by a complete course. The recurrence rate was 33%, which varied with histology as specific recurrence rates for grades 1 to 3 tumors (18%, 33% and 50%, respectively). The only cancer related mortalities occurred with grade 3 tumors. These tumors also had a higher incidence of understanding and vascular complications. Bacillus Calmette-Guerin therapy showed no significant improvement in survival.
With vigilant followup, percutaneous management of transitional cell carcinoma of the renal collecting system is an acceptable alternative to nephroureterectomy in patients with grade 1 disease, grade 2 disease who are at risk for renal insufficiency and medical contraindications to a major open operation.
我们旨在确定经皮切除肾集合系统移行细胞癌的有效性。
对9年间治疗的36个肾脏进行回顾性分析。19例患者接受了卡介苗辅助治疗。
36个肾脏中，6个因病情侵袭性强而立即行肾输尿管切除术，其余30个单位接受了完整疗程的治疗。复发率为33%，因组织学不同而有所差异，1至3级肿瘤的具体复发率分别为18%、33%和50%。仅3级肿瘤出现了与癌症相关的死亡。这些肿瘤还具有较高的理解和血管并发症发生率。卡介苗治疗在生存率方面未显示出显著改善。
通过密切随访，对于1级疾病、有肾功能不全风险的2级疾病以及存在重大开放性手术医学禁忌证的患者，经皮治疗肾集合系统移行细胞癌是肾输尿管切除术的一种可接受替代方案。
