Holm M, Miskowiak J, Rolff H
Urologisk afdeling, Bispebjerg Hospital, København.
Ugeskr Laeger. 1996 Jan 22;158(4):420-1.
Retrospective evaluation of the records of 574 patients with muscle-invasive bladder cancer revealed 90 patients (16%) with ureteric obstruction; the obstruction was bilateral in 24%. The effect of radiotherapy was assessed in 55 patients with 68 obstructed kidneys. Six patients with eight obstructed kidneys required percutaneous nephrostomy or ureteric catheters in addition to radiotherapy. Drainage improved in only 20% of kidneys and the diverting catheter could be withdrawn permanently in only one (17%) of the diverted patients. The median survival was 11 months. Irradiation was followed by significant complications in 37 patients (67%). This raises doubts about the assumed beneficial effect of irradiation on ureteric obstruction due to muscle invasive bladder cancer. The short median survival of 11 months confirms that ureteric obstruction is a poor prognostic factor in muscle invasive bladder cancer.
对574例肌层浸润性膀胱癌患者的病历进行回顾性评估发现，90例患者（16%）存在输尿管梗阻；其中24%为双侧梗阻。对55例伴有68个梗阻肾脏的患者评估了放疗效果。6例伴有8个梗阻肾脏的患者除放疗外还需要经皮肾造瘘术或输尿管插管。仅20%的肾脏引流得到改善，且仅1例（17%）接受改道的患者能够永久拔除改道导管。中位生存期为11个月。37例患者（67%）放疗后出现严重并发症。这使人对放疗对肌层浸润性膀胱癌所致输尿管梗阻的假定有益作用产生怀疑。11个月的短中位生存期证实输尿管梗阻是肌层浸润性膀胱癌的不良预后因素。
