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原发性尿道癌的管理

Management of primary urethral cancer.

作者信息

Gheiler E L, Tefilli M V, Tiguert R, de Oliveira J G, Pontes J E, Wood D P

机构信息

Department of Urology, Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Center Institute, Detroit, Michigan, USA.

出版信息

Urology. 1998 Sep;52(3):487-93. doi: 10.1016/s0090-4295(98)00199-x.

Abstract

OBJECTIVES

To determine the best therapeutic approach for treatment of patients with urethral cancer according to tumor location and clinical-pathologic stage.

METHODS

A retrospective review of 21 consecutive patients diagnosed with primary urethral carcinoma was performed. Clinical-pathologic staging, treatment modality, and outcome were analyzed.

RESULTS

The overall survival rate was 62%. In patients with clinical Stage Ta-2N0M0 tumors, 8 of 9 patients (89%) are free of disease compared to 5 of 12 patients (42%) with Stage T3-4N0-2M0 tumors (P = 0.03). Best treatment outcome for patients with Stage T3 disease or higher was obtained when multimodality therapy (neoadjuvant chemotherapy and radiation therapy with or without surgery) was administered, with a disease-free survival rate of 60%.

CONCLUSIONS

Clinical-pathologic stage was a strong predictor of disease-free survival rate. For patients with Ta-2N0M0 tumors, multimodality therapy may not be required. Conversely, best treatment outcomes in patients with T3-4N0-2M0 tumors are obtained by administering a multimodal therapy combining chemotherapy and radiation therapy with surgical resection.

摘要

目的

根据肿瘤位置和临床病理分期确定尿道癌患者的最佳治疗方法。

方法

对连续21例诊断为原发性尿道癌的患者进行回顾性研究。分析临床病理分期、治疗方式及结果。

结果

总生存率为62%。临床分期为Ta-2N0M0的肿瘤患者中,9例患者中有8例(89%)无疾病,而临床分期为T3-4N0-2M0的肿瘤患者中,12例患者中有5例(42%)无疾病(P = 0.03)。当采用多模式治疗(新辅助化疗和放疗,伴或不伴手术)时,T3期或更高分期患者的治疗效果最佳,无病生存率为60%。

结论

临床病理分期是无病生存率的有力预测指标。对于Ta-2N0M0肿瘤患者,可能不需要多模式治疗。相反,对于T3-4N0-2M0肿瘤患者,通过化疗、放疗联合手术切除的多模式治疗可获得最佳治疗效果。

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