Gheiler E L, Tefilli M V, Tiguert R, de Oliveira J G, Pontes J E, Wood D P
Department of Urology, Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Center Institute, Detroit, Michigan, USA.
Urology. 1998 Sep;52(3):487-93. doi: 10.1016/s0090-4295(98)00199-x.
To determine the best therapeutic approach for treatment of patients with urethral cancer according to tumor location and clinical-pathologic stage.
A retrospective review of 21 consecutive patients diagnosed with primary urethral carcinoma was performed. Clinical-pathologic staging, treatment modality, and outcome were analyzed.
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%.
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.
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。
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。
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%。
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。
