Fernández Rodríguez A, Martínez Tores J L, Domínguez Molinero J F, Arrabal Martín M, Miján Ortiz J L, Pedraza Muriel V, Zuluaga Gómez A
Servicio de Urología, Hospital Universitario San Cecilio, Granada, España.
Arch Esp Urol. 1998 Sep;51(7):695-700.
To determine the efficacy of postoperative irradiation for locoregional tumor recurrence and in the prevention of distant metastasis in patients with upper urinary tract tumor treated by radical surgery.
51 urothelial tumors of the upper urinary tract, most of which had been treated by radical surgery (nephroureterectomy with resection of bladder cuff were analyzed. Since 1989 an adjuvant postoperative radiotherapy protocol (55 Gy) has been included for high grade and stage tumors. Tumor staging was done according to the Jewett-Marshall classification and the Mostoffi cytological grading.
Of the total number of cases analyzed, 16 received postoperative irradiation; of these, 5 (31%) showed recurrence. The recurrence rate was 47% for those treated by radical surgery alone. In patients with stage C tumors, 5 out of 12 cases (41.6%) showed recurrence. The recurrence rate was higher (83%) for patients with stage C tumors treated by radical surgery alone.
Adjuvant postoperative radiotherapy is advocated for high grade and stage upper urinary tract tumors. This therapeutic approach has been found to reduce the number of recurrences and, consequently, morbidity. Although the overall survival rate did not increase, a larger series may show more consistent results in this regard.
确定术后放疗对接受根治性手术治疗的上尿路肿瘤患者局部区域肿瘤复发及预防远处转移的疗效。
分析了51例上尿路尿路上皮肿瘤，其中大多数已接受根治性手术（肾输尿管切除术并切除膀胱袖口）。自1989年以来，对于高级别和高分期肿瘤采用了辅助性术后放疗方案（55 Gy）。肿瘤分期根据Jewett-Marshall分类法和Mostoffi细胞学分级进行。
在分析的病例总数中，16例接受了术后放疗；其中5例（31%）出现复发。单纯接受根治性手术治疗的患者复发率为47%。在C期肿瘤患者中，12例中有5例（41.6%）出现复发。单纯接受根治性手术治疗的C期肿瘤患者复发率更高（83%）。
对于高级别和高分期的上尿路肿瘤，提倡辅助性术后放疗。已发现这种治疗方法可减少复发次数，从而降低发病率。尽管总体生存率没有提高，但更大规模的系列研究可能在这方面显示出更一致的结果。
