Grade 3成分を含む表在性膀胱癌の臨床的検討

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1986年1月からの10年間に治療されたgrade 3成分を含む表在性膀胱癌患者33例についてretrospectiveに検討した. 1)33例中3例は膀胱癌以外の疾患で死亡し,6例が膀胱癌にて死亡した.2年生存率は83%,5年生存率は75%,平均観察期間は50ヵ月であった. 2)単変量解析では腫瘍形態と腫瘍の大きさが有意な予後判定因子であったA retrospective study was done on 33 patients treated for superficial bladder cancer, pTa and pT1, with grade 3 components between 1986 and 1995. All patients had undergone transurethral resection of the tumor (TUR-Bt), which was followed by total cystectomy in 7 patients. Three patients died of pulmonary diseases or heart attack and 6 patients subsequently died of bladder cancer. The 2-year and 5-year disease-specific survival rates of these patients were 83% and 75%, respectively, and the mean duration of follow-up was 50 months. Comparison of the disease-specific survival rates for several factors revealed that the configuration and size of the tumors were significantly predictable factors for prognosis. In well-selected patients with grade 3 superficial bladder cancer, bladder preservation seems to be possible by TUR with or without adjuvant therapies. Hence further studies on a larger series are needed to elucidate more feasible and reliable prognostic factors to avoid unnecessary cystectomy and improve the quality of life of the patients.