Garzotto M G, Tewari A, Wajsman Z
Division of Urology, University of Florida, Gainesville 32610, USA.
J Surg Oncol. 1996 May;62(1):46-8. doi: 10.1002/(SICI)1096-9098(199605)62:1<46::AID-JSO10>3.0.CO;2-R.
Both radical cystectomy and diverticulectomy for the treatment of neoplasms arising in a vesical diverticulum have resulted in poor survival, mainly secondary to early metastatic spread. In this study, nine patients were treated with a multispecialty approach in hopes of eradicating both local and distant disease. All patients underwent a combination of therapeutic modalities with three patients undergoing pre-operative radiotherapy (RT) and diverticulectomy; diverticulectomy and chemotherapy (three patients); diverticulectomy with chemotherapy and pre-operative RT (two patients); and definitive RT with cisplatin (one patient). With a mean follow-up of 4.0 years (median 3.2), four patients are free of disease, two are dead of other causes, one patient has developed an invasive recurrence, one patient is alive with metastatic disease, and one patient is dead of disease. Five patients (55%) developed local recurrences. Disease-specific survival for the group was 89%. Surgical monotherapy has been ineffective in controlling both local and metastatic disease in patients with diverticular tumors. This study suggests a significant benefit from systemic chemotherapy and RT when combined with surgery for these neoplasms.
根治性膀胱切除术和憩室切除术用于治疗膀胱憩室内发生的肿瘤，其生存率均较低，主要是由于早期发生转移扩散。在本研究中，9例患者接受了多学科治疗方法，以期根除局部和远处疾病。所有患者均接受了多种治疗方式的联合治疗，其中3例患者接受了术前放疗（RT）和憩室切除术；3例患者接受了憩室切除术和化疗；2例患者接受了憩室切除术、化疗和术前RT；1例患者接受了顺铂根治性RT。平均随访4.0年（中位数3.2年），4例患者无疾病，2例死于其他原因，1例发生侵袭性复发，1例患者带转移瘤存活，1例患者死于疾病。5例患者（55%）发生局部复发。该组患者的疾病特异性生存率为89%。手术单一疗法在控制憩室肿瘤患者的局部和转移性疾病方面无效。本研究表明，对于这些肿瘤，全身化疗和RT与手术联合使用具有显著益处。
