双侧上尿路尿路上皮癌30例临床诊疗分析

doi:10.3969/j.issn.1006-7795.2014.03.005

首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (3): 290-294.doi: 10.3969/j.issn.1006-7795.2014.03.005

• 泌尿外科基础临床研究 • 上一篇下一篇

双侧上尿路尿路上皮癌30例临床诊疗分析

康永明^1,2, 方冬^1,3, 李学松^1,3, 周利群^1,3

1. 北京大学第一医院泌尿外科, 北京 100034;
2. 四川省遂宁市中心医院泌尿外科, 四川遂宁 629000;
3. 北京大学泌尿外科研究所国家泌尿、男性生殖系肿瘤研究中心, 北京 100034

收稿日期:2014-03-19 出版日期:2014-06-21 发布日期:2014-06-14
通讯作者: 李学松，E-mail：pineneedle@sina.com E-mail:pineneedle@sina.com
基金资助:
北京大学与台湾大学医学合作研究项目（BMU20120318）。

Treatment strategies of bilateral upper urinary tract urothelial carcinoma：clinical analysis of 30 cases

Kang Yongming^1,2, Fang Dong^1,3, Li Xuesong^1,3, Zhou Liqun^1,3

1. Department of Urology, Peking University First Hospital, Beijing 100034, China;
2. Department of Urology, Suining Central Hospital, Suining 629000, Sichuan Province, China;
3. Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China

Received:2014-03-19 Online:2014-06-21 Published:2014-06-14
Supported by:
This study was supported by Collaborative Research Foundation of Peking University Health Science Center and National Taiwan University, College of Medicine(BMU20120318).

摘要/Abstract

摘要：

目的探讨双侧上尿路尿路上皮癌的临床治疗策略。方法回顾性分析北京大学第一医院2002年1月至2011年5月诊治的30例原发性双侧上尿路尿路上皮癌患者，根据患者肾功能分组，按eGFR≥60 mL/min，15 mL/min≤eGFR< 60 mL/min，eGFR< 15 mL/min分为A、B、C 3组，A、B组患者主要采用一侧保留肾功能和另一侧根治性切除的主要治疗方式，C组患者主要采用双侧根治性切除的方式治疗，分析各种手术方式对不同肾功能状态的上尿路尿路上皮癌患者的治疗效果。结果 30例患者手术治疗均取得成功，其中A组患者，术后肿瘤复发率为33.33%，1例患者术后肾衰竭行透析治疗，1例患者术后7年因肿瘤原因死亡。B组患者，尿路上皮肿瘤复发率为31.25%，3例患者随访期间因肾衰竭行透析治疗，3例患者死亡。C组患者术后均行透析治疗，尿路上皮肿瘤复发率为37.5%，随访期间死亡3例。3组生存率、复发率差异无统计学意义。结论应根据患者肾功能情况和肿瘤特征，选择合适的方式治疗双侧上尿路尿路上皮癌。保留肾功能的治疗方法对于双侧上尿路尿路上皮癌患者而言是一种可选的治疗方法。

关键词: 双侧, 上尿路尿路上皮癌, 手术治疗, 肾功能

Abstract:

Objective To explore the clinical treatment strategies of bilateral upper tract urothelial carcinoma. Methods Retrospective analysis of 30 cases who underwent operation for primary bilateral upper urinary tract urothelial carcinoma from January 2002 to May 2011 was performed. Patients were divided into 3 groups according to renal function: group A(eGFR≥60 mL/min), group B(15 mL/min≤eGFR<60 mL/min), group C(eGFR<15 mL/min). The main treatment for group A&B was unilateral nephron-sparing surgery and contralateral radical resection, and for Group C was bilateral radical excision. We analyzed treatment results of patients with different renal function. Results Surgeries on all cases were successful. Postoperative follow-up, showed that bladder tumor recurrence rate was 33.33% in group A; one patient needed dialysis and 1 patient died of tumor. In group B, urothelial tumor recurrence rate was 31.25%.Three patient needed dialysis and another 3 patients died of tumor. The rate of urothelial tumor recurrence in group C is 37.5%, and 3 patients died during the follow-up period. All patients needed dialysis in group C after operation. Conclusion Renal function and tumor characteristics are important in surgery selections of bilateral upper urinary tract urothelial tumors. Nephron-sparing surgery can be used as a alternative treatment.

Key words: bilateral, upper urinary tract urothelial carcinoma, surgical treatment, renal function

中图分类号:

R693

康永明, 方冬, 李学松, 周利群. 双侧上尿路尿路上皮癌30例临床诊疗分析[J]. 首都医科大学学报, 2014, 35(3): 290-294.

Kang Yongming, Fang Dong, Li Xuesong, Zhou Liqun. Treatment strategies of bilateral upper urinary tract urothelial carcinoma：clinical analysis of 30 cases[J]. Journal of Capital Medical University, 2014, 35(3): 290-294.

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双侧上尿路尿路上皮癌30例临床诊疗分析

Treatment strategies of bilateral upper urinary tract urothelial carcinoma：clinical analysis of 30 cases

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