抄録
(目的)腎盂尿管癌の治療成績,予後規定因子,膀胱再発率および術後補助療法の有用性について臨床的検討を行った.(対象と方法)1992年1月から2007年6月までに手術療法を施行した腎盂尿管癌107例を対象とし,Kaplan-Meier法,比例ハザード分析により解析した.(結果)全症例の疾患特異的5年生存率は88.1%,非進行5年生存率は51.2%,5年膀胱非再発率は64.9%であった.病理学的因子の多変量解析では扁平上皮化生の有無がもっとも予後に与える影響が大きいと考えられた.pT3以上の37例において,術後放射線化学療法施行群と非施行群の疾患特異的5年生存率はそれぞれ74.0%,78.3%であり,両群間に有意差を認めなかった.(結論)局所進行性腎盂尿管癌に対する放射線化学療法の有用性は認められず,補助療法については今後のさらなる検討が必要であると考えられた.
(Purpose) We retrospectively reviewed 107 patients of upper urinary tract carcinoma to determine the overall outcome, prognostic factors, frequency of subsequent bladder cancer and role of adjuvant therapy. (Materials and methods) 107 patients of upper urinary tract carcinoma, who underwent surgical treatment at Sumitomo Hospital between January 1992 and June 2007 were reviewed. The Kaplan-Meier method and Cox's proportional hazard model were used. (Results) Five-year disease specific survival, progression free survival and bladder recurrence free rates in all patients were 88.1%, 51.2% and 64.9% respectively. Multivariate analysis revealed squamous differentiation to be the most important prognostic factor. Five-year disease specific survival in locally advanced upper urinary tract carcinoma treated with adjuvant chemoradiation was 74.0%, which was not statistically different from it without chemoradiation. (Conclusion) Our series suggests that the adjuvant chemoradiation does not improve the outcome in patients with locally advanced upper urinary tract carcinoma.
