Grigsby P W
Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Int J Radiat Oncol Biol Phys. 1998 Jun 1;41(3):535-41. doi: 10.1016/s0360-3016(97)00773-6.
This analysis was performed to evaluate the influence of clinical and treatment factors on local tumor control, survival, and complications for women with urethral carcinoma.
The records of 44 women with carcinoma of the urethra were reviewed. Their age ranged from 37 to 89 years (mean, 67 years). Mean follow-up time was 8.25 years. The stages of disease were T1 in eight, T2 in five, T3 in 22, and T4 in nine. Treatment was with surgery in 7, radiotherapy in 25, and combined surgery and radiotherapy in 12.
The 5-year overall survival was 42% and the 5-year cause-specific survival was 40%. At the time of last follow-up, 11 women were alive and 33 were dead. Recurrence of tumor occurred in 27 women and was the cause of death for 23. Recurrence was local in 8, local and distant in 15, and distant in 4. Severe complications occurred in nine women (20%). The severe complication rate was 29% (2 of 7) for women treated with surgery, 24% (6 of 25) for women treated with radiotherapy, and 8% (1 of 12) for women treated with surgery and radiotherapy. A multivariate analysis was performed to evaluate the interaction of tumor size, histology, and location, and lymph node status. This analysis indicated that tumor size and histology were independent prognostic factors for survival and local tumor control. Adenocarcinoma occurred in 13 women, and none of them were alive at 5 years. Only 1 of 10 women with tumors greater than 4 cm was alive at 5 years.
The most significant clinical factors affecting prognosis were tumor size and histology. Tumor location was not an independent prognostic variable. None of the women with adenocarcinoma, and only one woman with a tumor greater than 4 cm was alive at 5 years, irrespective of modality of treatment. Aggressive treatment resulted in a high complication rate.
进行本分析以评估临床和治疗因素对尿道癌女性患者局部肿瘤控制、生存及并发症的影响。
回顾了44例尿道癌女性患者的记录。她们的年龄在37至89岁之间（平均67岁）。平均随访时间为8.25年。疾病分期为T1期8例，T2期5例，T3期22例，T4期9例。7例接受手术治疗，25例接受放射治疗，12例接受手术联合放射治疗。
5年总生存率为42%，5年病因特异性生存率为40%。在最后一次随访时，11例女性存活，33例死亡。27例女性出现肿瘤复发，其中23例因复发死亡。8例为局部复发，15例为局部及远处复发，4例为远处复发。9例女性（20%）发生严重并发症。手术治疗的女性严重并发症发生率为29%（7例中的2例），放射治疗的女性为24%（25例中的6例），手术联合放射治疗的女性为8%（12例中的1例）。进行多因素分析以评估肿瘤大小、组织学、位置及淋巴结状态之间的相互作用。该分析表明，肿瘤大小和组织学是生存及局部肿瘤控制的独立预后因素。13例女性为腺癌，其中无1例在5年后存活。肿瘤大于4 cm的10例女性中，仅1例在5年后存活。
影响预后的最显著临床因素为肿瘤大小和组织学。肿瘤位置不是独立的预后变量。无论治疗方式如何，腺癌女性患者无1例在5年后存活，肿瘤大于4 cm的女性患者仅1例在5年后存活。积极治疗导致高并发症发生率。
