腎盂尿管癌の臨床的検討 : 初診時の肉眼的血尿の有無による比較も含めて

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We analyzed 95 patients with renal pelvic and ureteral cancers with total nephroureterectomy at our Department fromJanuary, 1997 to April, 2007. The patients were composed of 60 males and 35 females, between 41- and 90-years-old with a median age of 69-years-old. Histologically, there were 94 transitional cell carcinomas (TCC) and 1 TCC with squamous cell carcinoma. Fifty five cases (57.9%) were less than pT2, and 41 cases (42.1%) were more than pT3. Findings of lymphatic and venous invasion were present in 35 cases and 24 cases respectively. The overall survival rate at 5 years was 76.6%. In this series, pathological stage, infiltration pattern, lymphatic and/or venous invasion and the regional lymph nodes indicated a significantly poor prognosis. On the other hand, multivariate analysis using Cox proportional hazards regression revealed the presence of pathological stage as the most significant predictor of survival. Furthermore, we investigated histopathological prognostic factors of the patients separating asymptomatic macrohematuria group (AM group) and non-asymptomatic macrohematuria group (non-AM group). According to this analysis, non-AM group had worse pathological stage, grade and lymphatic invasion than AM group.
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