摘要
目的探讨原发性上尿路鳞癌的诊断、治疗及预后情况。方法对2006年7月至2018年4月郑州市第三人民医院收治的14例经术后病理检查证实为上尿路鳞癌患者的临床资料进行回顾性分析,包括其临床症状、检查、治疗及预后情况。结果14例原发性上尿路鳞癌患者中,男11例,女3例,男女比例3.7:1。年龄40~75岁,中位年龄58.6岁。肾盂肿瘤8例,输尿管肿瘤6例。其中出现腹膜后淋巴结转移8例,远处转移1例。所有患者均行手术治疗,其中术后全身化疗3例、放疗1例、放疗+化疗1例。11例术后出现局部复发或远处转移。1、2、3 a生存率分别为71.4%、42.8%、14.2%,生存期最短者7个月,最长者随访45个月仍无病生存,中位生存期20个月。结论原发性上尿路鳞癌预后差,早期诊断很重要,应尽早行根治性肾输尿管切除+膀胱袖状部分切除以改善患者预后,对于高风险患者应行局部淋巴结清扫,在上尿路鳞癌治疗中放疗和化疗的作用仍需进一步探讨。
Objective To study the clinical features,diagnosis,treatment and survival of the squamous cell carcinoma of the upper urinary tract.Methods The clinical data of 14 patients with squamous cell carcinoma of the upper urinary from July 2006 to April 2018 in the Third People’s Hospital of Zhengzhou City were reviewed.Results Among the 14 patients,11 patients were male and 3 patients were female,the median age was 58.6 years.Eight patients with renal pelvic tumors and 6 patients with ureteral tumors.Eight patients had retroperitoneal lymphnode metastases,and 1 patient had distant metastases.All the patients were treated with surgery,postoperative systemic chemotherapy in 3 patients,radiotherapy in 1 patient,radiotherapy and chemotherapy in 1 patient,and 11 patients had local recurrence or distant metastasis after surgery.The 1-,2-and 3-year survival rates for all the patients were 71.4%,42.8%and 14.2%respectively.The shortest survival period was 7 months,the longest was still disease-free after 45 months of follow-up,the median survival period was 20 months.Conclusion The prognosis of squamous cell carcinoma of upper urinary tract is relatively poor,it is very important for the patients to be early-diagnosed and early-treated.Radical nephroureterectomy and ureterectomy remains the mainstay of therapy for squamous cell carcinoma of the upper urinary tract.Local lymph node dissection should be performed for high-risk patients.The role of radiotherapy and chemotherapy in the treatment of squamous cell carinoma of the upper tract needs further study.
作者
王雷阳
范帅
张力
葛永超
常保东
WANG Leiyang;FAN Shuai;ZHANG Li;GE Yongchao;CHANG Baodong(Department of Urology,the Third People’s Hospital of Zhengzhou City,Zhengzhou 450000,China)
出处
《肿瘤基础与临床》
2023年第3期220-222,共3页
journal of basic and clinical oncology
关键词
上尿路鳞癌
诊断
治疗
squamous cell carcinoma of the upper tract
diagnosis
treatment
作者简介
王雷阳(1986-),男,硕士,主治医师,主要从事泌尿系统肿瘤基础与临床研究。E-mail:348037016@qq.com;通信作者:葛永超(1964-),男,本科,主任医师,主要从事泌尿系统肿瘤基础与临床研究。E-mail:yongchaogyc@163.com。
